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1.
BMC Pregnancy Childbirth ; 23(1): 575, 2023 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-37563737

RESUMEN

BACKGROUND: A minimum length of stay following facility birth is a prerequisite for women and newborns to receive the recommended monitoring and package of postnatal care. The first postnatal care guidelines in Cameroon were issued in 1998 but adherence to minimum length of stay has not been assessed thus far. The objective of this study was to estimate the average length of stay and identify determinants of early discharge after facility birth. METHODS: We analyzed the Cameroon 2018 Demographic and Health Survey. We included 4,567 women who had a live birth in a heath facility between 2013 and 2018. We calculated their median length of stay in hours by mode of birth and the proportion discharged early (length of stay < 24 h after vaginal birth or < 5 days after caesarean section). We assessed the association between sociodemographic, context-related, facility-related, obstetric and need-related factors and early discharge using bivariate and multivariable logistic regression. RESULTS: The median length of stay (inter quartile range) was 36 (9-84) hours after vaginal birth (n = 4,290) and 252 (132-300) hours after caesarean section (n = 277). We found that 28.8% of all women who gave birth in health facilities were discharged too early (29.7% of women with vaginal birth and 15.1% after a caesarean section). Factors which significantly predicted early discharge in multivariable regression were: maternal age < 20 years (compared to 20-29 years, aOR: 1.44; 95%CI 1.13-1.82), unemployment (aOR: 0.78; 95%CI: 0.63-0.96), non-Christian religions (aOR: 1.65; 95CI: 1.21-2.24), and region of residence-Northern zone aOR:9.95 (95%CI:6.53-15.17) and Forest zone aOR:2.51 (95%CI:1.79-3.53) compared to the country's capital cities (Douala or Yaounde). None of the obstetric characteristics was associated with early discharge. CONCLUSIONS: More than 1 in 4 women who gave birth in facilities in Cameroon were discharged too early; this mostly affected women following vaginal birth. The reasons leading to lack of adherence to postnatal care guidelines should be better understood and addressed to reduce preventable complications and provide better support to women and newborns during this critical period.


Asunto(s)
Cesárea , Alta del Paciente , Embarazo , Recién Nacido , Femenino , Humanos , Adulto Joven , Adulto , Tiempo de Internación , Camerún/epidemiología , Parto , Demografía
2.
Pan Afr Med J ; 37(Suppl 1): 19, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33343798

RESUMEN

INTRODUCTION: WHO warned against a dramatic impact of COVID-19 in Africa unless adequate response strategies are implemented. Whatever the strategy, the role of health staff is pivotal. Objective: Assess knowledge and perception of the response to COVID-19 among health staff. METHODS: we used a convenience non probabilistic sample to conduct a survey with a self-administered questionnaire from April 14 - 29, 2020 at the Bafoussam Regional Hospital (BRH). All the staff was invited to participate. Analyses were done with Microsoft Excel 2010 and Epi-Info version 7.1.5.2. RESULTS: response rate was 76.1% (464/610). Mean age (SD) was 35.0 (8.9) years. Sex ratio (M/F) was 101/356. Nursing/midwifery staff (56.8%) and in-patients units (49.94%) were predominant. Origin and transmission of SARS-CoV-2 were poorly known while knowledge of clinical signs and the role of laboratory tests were good. For 53.2% of respondents all therapeutic regimens are supportive and only 31.6% trusted state-recommended drugs. For 169 of respondents (36.9%), herbal remedies prevent/cure COVID-19. Seventy percent (70%) felt they were not knowledgeable enough to handle COVID-19 cases. Eighty-five point six percent (85.6%) thought the BRH had insufficient resources to fight COVID-19 and 55.6% were dissatisfied with its response (weaknesses: medicines/technologies (74.5%), service delivery (28.1%), staff (10.9%)). Sixty-eight percent (68%) reported insufficient protection on duty. Seventy-six point five percent (76.5%) reported a drop in non-COVID-19 services. Eighty-five point five (85.5%) percent said they complied with community preventive measures. For 44% of respondents, regulations on COVID-19 corpses should be made more culture-sensitive. Fifty one point two percent (51.2%) of respondents were against vaccine trial in their community. CONCLUSION: knowledge was poor and perception of the response to COVID-19 was unfavourable.


Asunto(s)
COVID-19/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Personal de Hospital/estadística & datos numéricos , Adulto , Anciano , Actitud del Personal de Salud , COVID-19/terapia , Camerún , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
3.
Pan Afr Med J ; 35: 23, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32341744

RESUMEN

INTRODUCTION: The coiling of umbilical cord is the winding of the umbilical cord around a part of the fetal body once or several times. It is the most common abnormality of the cord, its prevalence varies according to the authors from 5.7% to 35.1%. In 2011, the rate of perinatal mortality due to the coiling of umbilical cord in Cameroun was 6.1%. However factors associated to it are little known in our context. Our purpose was to determine factors associated to the coiling of umbilical cord in three hospitals in Yaoundé. METHODS: We conducted an analytical case-control study in the Maternity Unit at the Central Hospital of Yaoundé, the University Teaching Hospital of Yaoundé and the Social and Health Nkoldongo Animation Center over a period of 4 months. The study-group composed of newborns with coiling of umbilical cord was compared with two control groups (newborns without coiling of umbilical cord). All the fetuses were cephalic at delivery (singleton pregnancies at term). Pre-established technical data sheets were filled with data collected and analyzed based on the Microsoft Excel 2017 and SPSS software Version 23. The parameters used for the analysis were the average age, standard deviation and frequency, the raw odds ratio (OR) and/or adjusted (aOR) with their 95% confidence interval. P was considered significant for any value less than 5. RESULTS: Out of a total of 3,300 deliveries, 500 newborns (15.15%) had coiling of umbilical cord. All the coils were around the neck. We retained and studied 136 newborns with coiling of umbilical cord (study group) vs 272 newborns without coiling of umbilical cord (control group). Factors independently associated with coiling were non editable: length of the cord = 70cm (ORa = 32 CI = 17.5-35 p = 0.02), male sex (ORa = 67.09 CI = 22.31 - 97.46 P = 0.001), APGAR score 5th minute <7 (ORa =76.98 CI = 2.19 - 27.05 P=0.017) and modifiable factors were gestational age = 42WA (ORa = 15.15 CI = 6.14-18.2 P = 0.001). CONCLUSION: The coiling of umbilical cord is a frequent cord abnormality. We suggest to the decision-makers to increase awareness among health workers and the population on the importance of ultrasound scan of the third trimester in order to detect coiling of umbilical cord and implement appropriate manage newborns. Clinicians should avoid as much as possible post-term pregnancy.


Asunto(s)
Enfermedades Fetales/epidemiología , Enfermedades Fetales/etiología , Cordón Umbilical/anomalías , Adulto , Puntaje de Apgar , Camerún/epidemiología , Estudios de Casos y Controles , Femenino , Enfermedades Fetales/diagnóstico , Edad Gestacional , Maternidades/estadística & datos numéricos , Humanos , Recién Nacido , Masculino , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/etiología , Resultado del Embarazo/epidemiología , Pronóstico , Factores de Riesgo , Ultrasonografía Prenatal , Cordón Umbilical/diagnóstico por imagen , Cordón Umbilical/patología
4.
Adv Prev Med ; 2020: 1603518, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32158562

RESUMEN

Introduction. Tetanus vaccination plays an important role in the fight against neonatal mortality. Our study aimed to determine the noncompletion rate of the 3rd dose of tetanus toxoid vaccine (TTV) and to analyze the associated factors in pregnant women. METHODS: This was a cross-sectional study conducted in 2 hospitals of Dschang Health District and targeting all women at least in their second gestation coming for antenatal consultation. Upon informed consent by the participant, a prepared questionnaire was administered. The collected data was analyzed using SPSS v22.0 with results presented in means and proportions. Logistic regression was used at two levels to identify independently associated factors for noncompletion of the third dose of TTV with a significance set at 5%. RESULTS: A total of 380 pregnant women were recruited in this study of mean age 27 ± 5.2 yrs, 70% being married, more than 80% having at least secondary education, and 31.8% of them being students. It was noted that 172 (45.26%) of these women had not received the third dose of TTV. The analysis of the adjusted effects showed that not going to postnatal consultation (aOR = 6.75; 3.98-11.49, p < 0.0001), not accompanying her baby to vaccination (aOR = 3.784; 1.803-7.942, p < 0.0001), not accompanying her baby to vaccination (aOR = 3.784; 1.803-7.942, p < 0.0001), not accompanying her baby to vaccination (aOR = 3.784; 1.803-7.942. CONCLUSION: Tetanus vaccination coverage is not yet optimal in Dschang Health District and is associated with marital status as well as postgestational behavior of the mothers. There is thus the need to put in place strategies that will provide social support to single mothers as well as encourage women to attend postnatal consultation and to accompany their own children for vaccination. Furthermore, community-based vaccination could capture some of the lost women thus optimizing the overall vaccination coverage.

5.
Health sci. dis ; 20(5)2019.
Artículo en Francés | AIM (África) | ID: biblio-1262826

RESUMEN

Introduction.: la dysménorrhée est une situation fréquente chez les femmes en âge de procréer. Elle affecte la qualité de vie des filles et est la principale cause d'absentéismes scolaires chez les adolescentes. Notre étude avait pour objectif d'analyser les facteurs associés à la dysménorrhée et les aspects psychosociaux de la dysménorrhée chez les élèves et étudiantes à Yaoundé. Méthodologie. L'étude était transversale analytique, réalisée dans 2 établissements secondaires et un établissement supérieur de la ville de Yaoundé, du 1er Décembre 2017 au 30 Juin 2018 soit une durée de 6 mois. Étaient incluses toutes les élèves et étudiantes âgées de 15 ans et plus, ayant leurs menstruations et au moins un niveau d'instruction de la classe de seconde. L'échantillonnage était stratifié en grappe de 2 niveaux dans l'un des établissements et consécutif dans un autre. Le rapport de côte a été utilisé pour rechercher les associations entre les variables et la valeur P ˂ 0,05 était considérée significative. Résultats. Parmi les 1059 participantes, 800 avaient des dysménorrhées soit une prévalence de 75,5%. La moyenne d'âge était de 18,88 ± 3,62 ans avec des extrêmes allant de 15 à 45 ans. Les facteurs de risque de la dysménorrhée étaient : indépendamment associés aux dysménorrhées étaient les antécédents familiaux de dysménorrhée [OR (IC à 95%) : 4,20(3,02-5,83)] et le stress [OR (IC à 95%) : 2,16(1,55-3,02] ; tandis que la durée des règles ≤ 3 jours [OR (IC 95%) : 0,31(0,12-0,82)] est un facteur protecteur. La dysménorrhée était considérée comme un sujet tabou par 23,6 % des participantes. Conclusion. Les antécédents familiaux de dysménorrhée et le stress sont des facteurs de risque de la dysménorrhée. Certaines personnes affectées préfèrent ne pas en parler. Nous recommandons de sensibiliser les femmes sur la dysménorrhée et les aider à lutter contre le stress


Asunto(s)
Camerún , Cultura , Dismenorrea/diagnóstico , Dismenorrea/epidemiología , Dismenorrea/prevención & control
6.
Clin Med Insights Reprod Health ; 12: 1179558118770671, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29692639

RESUMEN

BACKGROUND AND RATIONALE: Viral hepatitis B (VHB) and viral hepatitis C (VHC) are major public health issues in resource-poor countries where vertical transmission remains high. AIM: To assess prevalences and correlates of VHB and VHC among women attending antenatal clinic. METHODS: A cross-sectional study at the Yaounde Central Hospital from January 1 to June 30, 2016. We included 360 pregnant women who were screened for hepatitis B virus surface antigen (HbsAg) and VHCAb by rapid diagnostic test (DiaSpot Diagnostics, USA) followed by confirmation of positive results by a reference laboratory. Odds ratios (95% confidence interval [CI]) were used to measure associations between variables. Statistical significance was set for P-value <.05. RESULTS: Mean age was 27.9 ± 5.6 years. The prevalences of HbsAg and VHCAb were 9.4% (n = 34) and 1.7% (n = 6), respectively. Multiplicity of sex partners was significantly associated with HbsAg positivity (adjusted odds ratio [aOR]: 11.6; 95% CI: 5.1-26.7; P < .001) while none of the studied factors was associated with VHCAb. CONCLUSION: The high prevalence of hepatitis B among pregnant women supports systematic screening and free vaccination of pregnant women and women of childbearing age.

7.
Pan Afr Med J ; 27: 248, 2017.
Artículo en Francés | MEDLINE | ID: mdl-28979649

RESUMEN

INTRODUCTION: The World Health Organization (WHO) estimates that 585.000 women die every year in the world as a result of complications related to pregnancy, delivery, postpartum period and abortion (the latter contributing to 13% of maternal deaths). Ectopic pregnancies are responsible for 10% of maternal mortality in the first quarter of pregnancy. Maternal mortality rate is high in Cameroon, estimated at 782 per 100.000 live births according to EDS-MICS 2011. AS the role of these two conditions in maternal mortality is little documented in our country, we conducted this study to assess the role of abortions and ectopic pregnancies in maternal mortality rate in Cameroon. METHODS: We conducted a retrospective and analytic study. We collected data from all the medical records of pregnant patients and pregnant patients died before the 28thweek of pregnancy at three university hospitals: Central Hospital of Yaoundé (HCY), Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital (HGOPY), University Hospital (CHU), over a period of five years, from 1 June 2011 to 31 May 2016. Data were recorded on a pre-established and tested technical sheet, collected using CS Pro 6.2 software and analyzed using SPSS software 20. The statistical tests for comparison used were Khi 2 and Fischer test according to the effective sample. The threshold significance level was set at p <0.05. RESULTS: We recorded 524 maternal deaths per 31116 live births, reflecting a maternal mortality rate (MMR) of 1538,9/100 000 live births. Out of 524 maternal deaths, 414 medical records were workable, including 100 (24.2%)abortions and 24 (5.8%) ectopic pregnancies. These 2 conditions contributed together to 30% of maternal deaths (124 medical records out of 414). The analysis of 124 medical records showed that the average age was 27.58 +/- 6 years, ranging from 18 to 48 years. The age group 20-24 years was the most represented (33.1%), followed by that 25-29 years (24.19%). The singles constituted 75%, housewives 36.7%, with level of secondary education in 62.5% and multigestes constituted 36.1% of our sample. 73.4% of patients didn't undergo any prenatal consultation and only 2.4% had undergone at least 4 consultations. Complications resulting in deaths were dominated by hemorrhage and infections. CONCLUSION: Abortions and ectopic pregnancies are the major causes of maternal mortality in our country. We recommend strengthening of family planning to limit unwanted pregnancies and socio-economic support for patients at risk.


Asunto(s)
Aborto Inducido/estadística & datos numéricos , Aborto Espontáneo/epidemiología , Mortalidad Materna , Embarazo Ectópico/epidemiología , Aborto Inducido/efectos adversos , Adolescente , Adulto , Camerún/epidemiología , Femenino , Hospitales Universitarios , Humanos , Muerte Materna/estadística & datos numéricos , Embarazo , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Estudios Retrospectivos , Adulto Joven
8.
Pan Afr Med J ; 28: 144, 2017.
Artículo en Francés | MEDLINE | ID: mdl-29564033

RESUMEN

INTRODUCTION: Genital tract integrity is not always mantained during childbirth. No treatment protocol for post-partum perineal wounds (tears and episiotomies) existed in our Department, thus their management depends upon clinician. This study aimed to establish the role of antibiotic in the treatment of post-partum perineal wounds as well as the impact of antibioprophylaxis on wound healing and on prevention of infectious complications after repair. METHODS: We conducted a prospective cohort study in the Department of Gynecology and Obstetrics at the Central Hospital of Yaoundé over a period of 6 months, from 1 January to 31 May 2016. Post-partum women with perineal tear and/or episiotomy were divided into two groups (A and B) and followed up. The group A was composed by 85 post-partum women under treatment protocol based on compresses soaked in Betadine® (placebo). The Group B (or test group) was composed of post-partum women who had received placebo plus antibiotic (oral amoxicillin/clavulanic acid 875 mg/125 mg twice a day for 05 days). Both groups were followed up on day 0, day 2 and day 9. Our criteria for the evaluation of treatment were: pain, infection, swelling, cleanliness of the wounds and average healing time. Data were collected and analyzed using the software Epidata analysis version 3.2 and STATA version 12.0 (Texas USA 2001). The correlations between the variables were identified by chi-square, odds ratio and p value (using any p-value ≤ 0.05 as statistical significance cut-off) according to the case. RESULTS: The average age was 26.32 ± 6.5 years, ranging between 15 and 43 years. Primiparous women accouted for 55.9% of the study population. At day 0 post-partum the main symptom was pain, without significant predominance of a group (OR = 0.9; CI = 0.14-7.19; p = 1). Swollen wounds were the second complaint, without significant variation between the two groups (OR = 1.69; CI = 0.88-3.24; p = 0.13). At day 0, day 2 and day 9 no significant variation was observed between the two treatment protocols with regard to the indicators analyzed: pain evolution, infection, swelling and average healing time. At day 9 the healing was complete in both groups and the two treatment protocols were shown to be equivalent in their effectiveness and prevention of infections. CONCLUSION: At the end of this study the two treatment protocols were shown to be equivalent. Antibiotics should not be prescribed for perineal wounds in order to contain the healthcare costs.


Asunto(s)
Antibacterianos/administración & dosificación , Episiotomía/efectos adversos , Laceraciones/tratamiento farmacológico , Cicatrización de Heridas/efectos de los fármacos , Adolescente , Adulto , Combinación Amoxicilina-Clavulanato de Potasio/administración & dosificación , Camerún , Estudios de Cohortes , Parto Obstétrico , Episiotomía/métodos , Femenino , Estudios de Seguimiento , Humanos , Infecciones/epidemiología , Dolor/epidemiología , Perineo/lesiones , Periodo Posparto , Povidona Yodada/administración & dosificación , Embarazo , Estudios Prospectivos , Resultado del Tratamiento , Adulto Joven
9.
Pan Afr Med J ; 28: 216, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29629002

RESUMEN

INTRODUCTION: Access to laparoscopy is low in Cameroon where customers' satisfaction has not been reported so far. We assessed patients' satisfaction with the process of care during laparoscopic surgery in a new tertiary hospital. METHODS: A questionnaire was addressed to consenting patients (guardians for patients under 18) with complete medical records who underwent laparoscopy at the Douala Gynaeco-Obstetric and Paediatric Hospital (Cameroon) from November 1, 2015 to July 31, 2016. The following modified Likert's scale was used to assess satisfaction: very weak: 0-2.5; weak 2.6-5; good: 5.1-7.5; very good: 7.6-10. Only descriptive statistics were used. RESULTS: Response rate was 90% (45/50). Of the 45 respondents, 39 (86.7%) were female, 14(31.1%) were referred and 39 (86.7%) paid by direct cash deposit. Mean age was 36.8±11.9 years. Laparoscopies were carried out in emergency for 3 (6.7%) patients. Digestive abnormalities indicated 13 (28.9%) laparoscopies while gynaecologic diseases accounted for 32 (71.1%) cases. Perception of the overall care process was good with a mean satisfaction score of 6.8 ± 1.4. Scores in categories were: 0% (Very weak); 13.3% (weak); 57.8% (good) and 28.9% (very good). Specifically mean satisfaction scores were: 7.8 ± 1.0 with doctors' care; 7.1 ± 1.3 with hospital administration; 7.0 ± 1.2 with nursing and 4.7 ± 1.4 with the costs. Main complaints were: long waiting time (73.3%), constraining geographical access (66.7%) and expensiveness (48.9%). CONCLUSION: Patients were globally satisfied with the process of care but financial and geographical barriers should be addressed.


Asunto(s)
Accesibilidad a los Servicios de Salud , Laparoscopía/métodos , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Camerún , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Centros de Atención Terciaria , Adulto Joven
10.
Pan Afr Med J ; 25: 207, 2016.
Artículo en Francés | MEDLINE | ID: mdl-28270904

RESUMEN

INTRODUCTION: Supposed benign ovarian tumors (SBOT) are considered one of the most frequent reasons for gynecological consultation and one of the most common indications for gynecological surgery. METHODS: We conducted a retrospective descriptive study in the Department of Obstetrics and Gynecology at the Central Hospital of Yaoundé. We carried out a 6-month study, over a five-year period, from 1 January 2010 to 31 December 2014. The study population consisted of all patients undergoing surgery for the treatment of supposed benign ovarian tumor during the study period. RESULTS: The mean age was 29.33 ± 6.83 with a minimum age of 20 years and a maximum age of 48 years. The most represented age range was 21-25 years. The reason for consultation was pelvic pain in 93.90% of the cases. Eleven patients were pregnant women (33.3% of our study population) and 72.70% were in their first trimester. SBOTs in our series were: cyst rupture (36.40%), ovarian torsion (adnexal torsion) (27.30%), voluminous ovarian cyst (21.20%) intracystic haemorrhage (15.20% ). 26 (78.78%) patients were treated conservatively. However, adnexectomy was performed in 5 out of 9 patients with ovarian torsion. CONCLUSION: Complex SBOTs can occur in our mids, especially in patients of reproductive age. Late diagnosis, especially in the case of ovarian torsion, obliges to perform radical procedure with deleterious effects upon the patient. Laparoscopy is the most recommended surgical procedure if the technical equipment is available because it reduces the risk of complications.


Asunto(s)
Laparoscopía/métodos , Quistes Ováricos/epidemiología , Neoplasias Ováricas/epidemiología , Complicaciones Neoplásicas del Embarazo/epidemiología , Enfermedades de los Anexos/epidemiología , Enfermedades de los Anexos/patología , Enfermedades de los Anexos/cirugía , Adulto , Camerún , Femenino , Hemorragia/etiología , Humanos , Persona de Mediana Edad , Quistes Ováricos/patología , Quistes Ováricos/cirugía , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Dolor Pélvico/etiología , Embarazo , Complicaciones Neoplásicas del Embarazo/cirugía , Estudios Retrospectivos , Anomalía Torsional/epidemiología , Anomalía Torsional/cirugía , Adulto Joven
11.
BMC Res Notes ; 8: 806, 2015 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-26686851

RESUMEN

BACKGROUND: Obesity is a rising public health issue worldwide. Guidelines regarding maternal body mass index (BMI) and gestational weight gain (GWG) are missing in Cameroon where maternal mortality rate remains very high. We hypothesized that obesity and inappropriate GWG are associated with poor pregnancy outcomes. We aimed at assessing associations of BMI and GWG with pregnancy outcomes. METHODS: This was a retrospective cohort study at the Yaoundé Central Hospital. We included women with term singleton deliveries in the post-partum ward. The World Health Organisation classification of BMI and the United States Institute Of Medicine (IOM) categories of GWG were used to stratify participants. Poor maternal outcome was defined by the occurence of caesarean section, preeclampsia or obstetrical haemorrhage. Poor perinatal outcome was defined by the occurence of perinatal death, admission in intensive care unit, low birth weight, macrosomia or fifth minute Apgar score <7. Multiple logistic regressions were used to calculate unadjusted and adjusted Odds Ratios (uOR, aOR) for poor maternal outcome (PMO) and for poor perinatal outcome (PPO) in each category of BMI and GWG. Adjustment was done for age, scarred uterus, sickle cell disease, malaria, human immunodeficiency virus (HIV) infection, parity and smoking. RESULTS: Of the 462 participants, 17 (4 %) were underweight (BMI < 18.5), 228 (49 %) had normal pre-pregnancy BMI, 152 (33 %) were overweight (25 ≤ BMI < 30) and 65 (14 %) were obese (BMI ≥ 30). Following the IOM recommendations, GWG was normal for 186 (40 %) participants, less than recommended for 131 (28 %) and above the recommended norms for 145 (32 %). GWG above the IOM recommendation was significantly associated with PMO (aOR: 1.7, 95 % CI 1.1-2.8). GWG less than the IOM recommended values, overweight and obesity were not significantly associated with poor pregnancy outcomes. CONCLUSION: While waiting for local recommendations for GWG, the IOM recommendations can be used for Cameroonian women as far as maternal outcome is concerned. Unlike in studies in different ethnic and racial groups, abnormal BMI was not associated with poor pregnancy outcomes in our cohort of Cameroonian women.


Asunto(s)
Índice de Masa Corporal , Sobrepeso/epidemiología , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Delgadez/epidemiología , Población Urbana/estadística & datos numéricos , Aumento de Peso , Adolescente , Adulto , Camerún/epidemiología , Femenino , Guías como Asunto , Humanos , Obesidad/epidemiología , Embarazo , Estudios Retrospectivos , Centros de Atención Terciaria/estadística & datos numéricos , Adulto Joven
13.
Pan Afr Med J ; 18: 181, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25419308

RESUMEN

We herein report a case of abdominal pregnancy managed in Yaounde (Cameroon). The 33 year old G5P2022 woman was referred to our setting for management of an abdominal pregnancy of 34 weeks diagnosed during the first routine obstetrical ultrasonography done two days earlier. This ultrasonography revealed a live foetus within intestinal loops with a severe oligoamnios. After two days of lung maturation, laparotomy was carried out and the live male baby weighed 2 600 grammes. The placenta was left on its implantation sites: omentun, uterine fundus and intestinal loops. The mother did well post-operatively and the resorption of the placenta took 11 months. The newborn presented compression deformities and died three days later of respiratory distress. This case illustrates that intra-abdominal fetuses can reach viability. Though rare, abdominal pregnancy remains a threat to mothers. Practitioners should therefore know the traps in its management.


Asunto(s)
Embarazo Abdominal/fisiopatología , Adulto , Diagnóstico Tardío , Resultado Fatal , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro , Laparotomía , Masculino , Enfermedad Inflamatoria Pélvica , Embarazo , Embarazo Abdominal/diagnóstico por imagen , Embarazo Abdominal/cirugía , Embarazo Tubario , Historia Reproductiva , Síndrome de Dificultad Respiratoria del Recién Nacido , Factores de Riesgo , Salpingectomía , Ultrasonografía Prenatal
15.
Pan Afr Med J ; 18: 86, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25400853

RESUMEN

Rudimentary uterine horn pregnancy is rare and, to our knowledge, has not been previously reported in Cameroon. We herein report the case of a 22 year old second gravida referred for acute abdominal pain at 17 weeks of gestation. Physical examination revealed hemoperitoneum with hypovolemic shock. After resuscitation, an emergency exploratory laparotomy was done and we found hemoperitoneum of 3,500 milliliters, a bicornuate uterus with a ruptured right rudimentary communicating horn containing a non viable foetus. There were no other abnormalities. We performed an excision of the rudimentary horn with ipsilateral salpingectomy. Post-operative course was uneventful and the woman was discharged seven days later. This case emphasizes the importance of good antenatal care to avoid complications.


Asunto(s)
Embarazo Ectópico/diagnóstico , Útero/anomalías , Camerún , Femenino , Humanos , Embarazo , Segundo Trimestre del Embarazo , Rotura Espontánea , Adulto Joven
19.
BMC Pregnancy Childbirth ; 14: 102, 2014 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-24636077

RESUMEN

BACKGROUND: Adolescent pregnancies are a growing public health problem in Cameroon. We sought to study the outcome of such pregnancies, in order to inform public health action. METHODS: A cross-sectional analysis of 5997 deliveries which compared the outcome of deliveries in adolescent (10-19 years old) pregnant women registered at the Yaoundé Central Hospital between 2008 and 2010 to that of their non-adolescent adult (≥ 20 years old) counterparts. Variables used for comparison included socio-demographic and obstetric characteristics of parturients, referral status, and maternal and fetal outcomes. Predictors of maternal and of perinatal mortality were determined through binomial logistic modeling. RESULTS: Adolescent deliveries represented 9.3% (560) of all pregnancies registered. Adolescent pregnancies had significantly higher rates of both gestational duration extremes: preterm as well as post-term deliveries (29.3% versus 24.5%, p = 0.041 OR 1.28 95% CI 1.01-1.62 and 4.9 versus 2.4%, p = 0.014 OR 2.11 95% CI 1.46-3.87 respectively). Both groups did not differ significantly with respect to mean blood loss, rates of cesarean or instrumental deliveries. Adolescent deliveries however required significantly twice as many episiotomies (OR 2.15 95% CI 1.59-2.90). The likelihood of perineal tears in the adolescent group was significantly higher than that in the adult group on assuming episiotomies done would have been tears if they had not been carried out (OR 1.45 95% CI 1.16-1.82). Adolescent parturients had a higher likelihood of apparent fetal death at birth as well as perinatal fetal death after resuscitation efforts (AOR 1.75 95% CI 1.25-2.47 and AOR 1.69 95% CI 1.17-2.45 respectively).Comparisons of pregnancy outcomes between early (10-14 years), middle (15-17 years) and late adolescence (18-19 years) found no significant differences. Predictors of maternal death included having been referred, having had ≥5 deliveries and preterm deliveries. These were also predictors of perinatal death, as well as being a single mother, primiparous, and multiple gestations. CONCLUSIONS: Adolescent pregnancies in Cameroon compared to those in adults are associated with poorer outcomes. There is need for adolescent-specific services to prevent teenage pregnancies as well as interventions to prevent and manage the above mentioned predictors of in-facility maternal and perinatal mortality.


Asunto(s)
Parto Obstétrico/métodos , Hospitales Urbanos/estadística & datos numéricos , Paridad , Embarazo en Adolescencia , Embarazo Múltiple , Nacimiento Prematuro/epidemiología , Adolescente , Adulto , Camerún/epidemiología , Cesárea/estadística & datos numéricos , Estudios Transversales , Femenino , Muerte Fetal/epidemiología , Humanos , Mortalidad Materna/tendencias , Persona de Mediana Edad , Mortalidad Perinatal , Embarazo , Resultado del Embarazo , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
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