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Informed Consent Prior to Elective Gynaecological Surgery in Two Reference Hospitals in Yaoundé, Cameroon: A Mixed Methods Study

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Open Journal of Obstetrics and Gynecology 2022年第9期12卷 958-978页

作者： Christiane Nsahlai ojong samuel Luchuo Engelbert Nseme Eric Tarkang Elvis Gouané Mathias Ombaku Kingsley Foumane Pascal Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Cameroon Global Health Research and Services Amsterdam The Netherlands Department of Pathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Cameroon School of Public Health University of Health and Allied Sciences Ho Ghana Yaounde Gynaeco-Obstetric and Paediatric Hospital Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Cameroon

Introduction: Informed consent is a process that enshrines respect for patients’ autonomy, their dignity, and their rights to determine what happens to their own bodies. We set out to describe the surgical informed consent process and evaluate its quality in patients undergoing elective gynaecological surgeries in two University Teaching Hospitals in Yaounde, Cameroon. Methods: This was a cross-sectional, prospective study over 9 month period, from October 1st, 2018, to June 30th, 2019 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH). By administering a modified Brezis questionnaire 48 hours after surgery, we obtained data which enabled us to evaluate and score the informed consent process and obtained written reports of patients’ appreciation of key aspects of the informed consent process prior to surgery. We then called each participant 6 months after their surgery date to obtain information on the occurrence or not of post-operative complications. Results: We recruited 72 patients aged 24 to 68 years old (61 at YGOPH, 11 at YCH). The operating gynaecologist sought patient consent in 65.3% (49/72) of cases, while 61.1% (44/72) of the subjects would have loved to have more information on surgical risks;69.4% (50/72) were satisfied with the consent process;and 56.9% (41/72) could recall and repeat the information they received prior to surgery. While 37.5% (27/72) had poor quality (non-valid consent), 40.3% had good quality consent (valid). Consent administered by the gynaecologist (OR = 0.172;95% CI = 0.060 - 0.049) was a strong determinant of valid consent. Also, patients with non-valid consent significantly reported more complications (OR = 4.469;95% CI = 1.412 - 14.147) than those with valid consent. Conclusion: Informed consent prior to elective gynaecological surgeries in our study was poor. The timing of the consent process, as well as the person involved in the process affect the va

关键词： Informed Consent Elective Gynaecological Surgery Yaounde

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Maternal and Foetal Outcomes Associated with Caesarean Deliveries in Patients with Severe Preeclampsia in Two Teaching Hospitals, Yaoundé

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1271-1281页

作者： Essiben Félix Ngo Um Meka Esther Mve Koh Valère Gwos Laurentine ojong samuel Foumane Pascal Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon Yaoundé Central Hospital Yaounde Cameroon Yaounde Gynaeco-Obstetric and Paediatric Hospital Yaounde Cameroon Yaounde Teaching Hospital Centre Yaounde Cameroon

Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p < 0.001), the persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001), Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p < 0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease (RR = 2.93, p Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications.

关键词： Preeclampsia Postoperative Complications Caesarean Section Yaoundé

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Patient Satisfaction after Elective Major Gynaecological Surgery in 2 Reference Hospitals in Yaounde: A Cross-Sectional Study

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Open Journal of Obstetrics and Gynecology 2022年第9期12卷 941-957页

作者： Christiane Nsahlai ojong samuel Luchuo Engelbert Bain Elvis E. Tarkang Ombaku Kingsley Mapina M. Alice Gouané Mathias Foumane Pascal Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Cameroon Department of Family Health Ministry of Public Health Cameroon

Introduction: Patient satisfaction is a quality-of-care measure and reveals patients’ appreciation of healthcare delivery. We sought to measure patient satisfaction following major gynaecological surgeries in 2 University Teaching Hospitals in Yaounde, Cameroon. Methods: This study was a cross-sectional, prospective study over 9 months (October 1st, 2018, to June 30th, 2019) at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH). By administering a modified Surgical Satisfaction Questionnaire (SSQ-8) via phone call 6 months after surgery, we appreciated and scored key aspects linked to patient satisfaction and obtained information on post-operative complications. Data were analysed using Microsoft Excel 18 and SPSS 21 setting significance at p Results: We recruited 72 patients aged 24 to 68 years. Our participants had a mean satisfaction score of 26 ± 7.854 (59.7% satisfied and 40.3% dissatisfied). All aspects tested on the SSQ-8 questionnaire influenced patient satisfaction. Patients who said they were satisfied with pain control after surgery (OR = 0.207 CI = 0.070 - 0.609, p = 0,003), and with surgical results in the SSQ-8 questionnaire (OR = 0.053, CI = 0.011 - 0.254, p < 0.001) achieved statistically significant post-operative satisfaction. Contrarily, patients who were dissatisfied with surgery results (OR = 132.000, CI = 15.256 - 114.131, p < 0.001) and those who developed complications (OR = 7.922, CI = 2.241 - 28.004, p < 0.001) were significantly dissatisfied with surgery. Additionally, 47.2% declared a poor post-operative current health status versus 52.8% who claimed a good post-operative current health status. Following multivariate analysis, satisfaction with the results of surgery (OR = 0.071, CI = 0.008 - 0.657, p = 0.020) and the occurrence of complications (OR = 7.284, CI = 1.146 - 46.273, p = 0.035) were the main determinants of patient satisfaction. Patient current health status evolved similarly t

关键词： Patient Satisfaction Elective Gynaecological Surgery Yaounde

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Histopathological Aspects of Placental Lesions in Mild and Severe Pre-Eclampsia in a Population of Cameroonian Women

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Open Journal of Obstetrics and Gynecology 2022年第2期12卷 154-168页

作者： Félix Essiben Ayissi Gregory Belinga Etienne Ndolo Kondo Astrid Ngo Dingom Madye Ange Ebong Cliford Ebontane ojong samuel Atomveng Foumane Pascal Yaoundé Central Hospital Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Central Maternity Yaoundé Central Hospital Yaoundé Cameroon Yaounde Gyneco-Obstetric and Pediatric Hospital Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon

Background: Pre-eclampsia (PE) frequently leads to adverse maternal and foetal outcomes in our setting. The pathophysiology is strongly linked to placental development. We aimed to study placental lesions associated with PE in a population of Cameroonian women. Methods: We conducted a cross-sectional, analytical study in three university teaching hospitals in Yaounde namely, the Yaounde Central Hospital, the pathology laboratory of the Yaounde University Hospital Centre, and the Yaounde Gynaeco-Obstetric and Paediatric Hospital. The study spanned 8 months from January 1st to September 1st, 2021. Placental analysis was carried out as per standard protocol. The study included 101 parturients with pre-eclampsia. These were divided into two groups, with groups 1 and 2 being made of patients with mild pre-eclampsia (n = 40), and severe pre-eclampsia (n = 61), respectively. Results: The mean ages of the two groups were 29.93 ± 7.36 versus 28.28 ± 7.18 (p = 0.267) for patients with mild and severe pre-eclampsia respectively. Low socioeconomic status was the most frequently identified risk factor in both groups (59%). Patients’ history revealed that the women with severe pre-eclampsia tended to have poor pregnancy follow-up compared to those with mild pre-eclampsia (p < 0.05). Also, the placentas of patients with severe pre-eclampsia weighed significantly less than those of patients with mild pre-eclampsia (454.4 ± 122 vs. 511.7 ± 125;p < 0.05). Pre-eclampsia-related lesions were significantly greater in patients with severe disease (p Conclusion: PE-related placental lesions in our context are multiple and diverse especially in severe disease, and these arise as a result of defective maternal vascular perfusion.

关键词： Preeclampsia Placental Lesions Histological Aspects Placental Dysfunction Cameroon

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Female Fertility Following Chemotherapy for Breast Cancer: A Descriptive Study of 265 Cases Treated in Yaounde

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Open Journal of Obstetrics and Gynecology 2020年第1期10卷 166-178页

作者： Félix Essiben Ngowa Jean Dupont Kemfang Aline Nganso Meka Juliette Esther Ngo Um Etienne Atenguena samuel ojong Paul Ndom Emile Telesphore Mboudou Yaoundé Central Hospital Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaounde Gyneco-Obstetric and Pediatric Hospital Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaounde General Hospital Yaoundé Cameroon Yaoundé General Hospital Department of Internal Medicine and Specialities Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Douala Gyneco-Obstetric and Pediatric Hospital Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Context: In Cameroon, breast cancer (BC) is usually diagnosed late in the disease course. About a third of women affected are aged less than 40 years. Chemotherapy (CT) could alter ovarian function and thereby compromise future fertility in these women. We therefore described the fertility of women following CT for BC in women treated at the Yaounde General Hospital (YGH). Methods: It was a retrospective, descriptive, cross-sectional study conducted over 8 months, from January to August 2017. We used the files of patients managed for BC from January 2011 to December 2015 in the medical oncology unit of the YGH. Results: We included 265 patients for the study following at least one year of CT. The mean age at the onset of CT was 35.9 ± 6.9 years. Most of the patients had fewer than 2 deliveries (68.3%). Intraductal carcinoma was the most frequent histological lesion (90.6%) and most often diagnosed in advanced stages (73.5%). As per CT, the FAC protocol was the most used (44.5%). The menstrual cycles of the patients were more regular prior to the onset of chemotherapy (89.4% vs. 58.9%), while the mean period of resumption of menstrual activity following cessation of chemotherapy was 6.3 ± 2.0 months. Chemotherapy-related amenorrhoea was observed in 29.1% of patients after 12 months of treatment. More than half of these women (51.3%) complained of a drop in libido and 6.4% achieved pregnancy within 13 months following cessation of chemotherapy. Conclusion: Following chemotherapy for BC, menstrual cycle disorders are more frequent and this can affect the patients’ reproductive potential. Fertility consultations should be integrated into the management plan of such patients.

关键词： Chemotherapy Fertility Women of Childbearing Age Breast Cancer Yaounde

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Referral and counter-referral practices in obstetric emergencies among health-care providers in selected health facilities in Plateau state,Nigeria

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Journal of Integrative Nursing 2022年第3期4卷 127-136页

作者： Alberta David NSEMO samuel Mahan Zakka MALAU Idang Neji ojong Department of Nursing Science University of CalabarCalabarCross River StateNigeria Department of Midwifery College of Nursing and MidwiferyVomPlateau StateNigeria

Objective:This study aimed to examine the referral and counter-referral practices in obstetric emergencies among health-care providers in selected health facilities in Plateau state of *** and Methods:A concurrent embedded descriptive mixed method consisting of both quantitative and qualitative methods was adopted for the ***(104)were recruited using multistage sampling and 8 participants using purposive sampling techniques for quantitative and qualitative aspects of the study,*** three-phase delay model directed the study.A self-developed structured questionnaire and an in-depth interview guide were used to elicit quantitative and qualitative responses from the *** instrument was tested for reliability,while the qualitative instrument went through the rigors of qualitative ***:Findings revealed low level of referral and counter-referral practices as only 19(18.27%)and 30(28.85%),respectively,of care providers referred patients above 10 times in a *** study also revealed inadequate human and material resources for referrals and *** mean on barriers to referral was 2.90,which was above the cutoff of mean of 2.50,which indicates that the barriers are militating against referral and counter-referral in obstetric ***:Low levels of referral and counter-referral practices are identified with inadequate resources among others posing as ***,provision of standard operational procedures/protocols in every health-care facility as well as provision of adequate material and skilled human resources among others is recommended to enhance referral and counter-referral network in obstetric *** is also a need for teamwork and synergy among all stakeholders in the referral chain.

关键词： Challenges counter‑referral health‑care facilities health‑care providers obstetric emergencies practices referral

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