Comparison of materno-fetal predictors and short-term outcomes between early and late onset pre-eclampsia in the low-income setting of Douala, Cameroon.

OBJECTIVE: To describe and compare materno-fetal predictors and short-term outcomes of early onset pre-eclampsia (EOPE) and late onset pre-eclampsia (LOPE) in Douala, Cameroon. METHODS: The present prospective hospital-based cross-sectional study included women with pre-eclampsia attending obstetric units at four hospitals in Douala between December 1, 2016, and April 30, 2017. To determine maternal predictors, sociodemographic and medical data were recorded using a pretested questionnaire. Pregnancy outcomes, and maternal and fetal adverse events were recorded. Univariate and multivariate logistic regression analyses were used to examine associations. RESULTS: Of 170 participants, 58 (34.1%) had EOPE and 112 (65.9%) had LOPE. EOPE was associated with higher incidences of chronic hypertension (P=0.027) and history of pre-eclampsia (P=0.003) compared with LOPE. Higher incidences of nulliparity and a different partner from prior pregnancy (P=0.024) were associated with LOPE. Women with EOPE had higher odds of acute kidney injury (odds ratio [OR] 6.67, 95% confidence interval [CI] 1.73-25.73) and HELLP (hemolysis, elevated liver enzyme, low platelets) syndrome (OR 10.47, 95% CI 1.19-91.9), and lower odds of deliveries without perinatal adverse events (OR 0.19, 95% CI 0.09-0.38), compared with patients with LOPE. CONCLUSION: In the low-income setting of Douala, there was a higher rate of LOPE than EOPE. Factors associated with EOPE and LOPE varied, and outcomes were worse for women with EOPE.

Occurrence of Lutembacher syndrome in a rural regional hospital: case report from Buea, Cameroon.

INTRODUCTION: Lutembacher syndrome (LS) is a rare cardiac clinical entity marked by the combination of an atrial septal defect (ASD) and mitral stenosis (MS). Its prognosis is influenced by several factors. CASE REPORT: We present the case of a young adult male who presented with a 10-month history of exertional dyspnea, orthopnoea, fatigue and cough. Clinical examination revealed features suggestive of advanced congestive heart failure. Echocardiography revealed severe MS and a secundum type ASD with pulmonary hypertension. Patient died on second day of admission. CONCLUSIONS: LS is a very rare condition. The outcome is better if treated before the onset of heart failure and pulmonary hypertension. However, surgical and percutaneous trans-catheter therapy is costly and not readily available in low-income settings in developing countries.