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Background: Emergency Obstetric Hysterectomy (EOH) is removal of the uterus due to life threatening conditions within the puerperium. This life saving intervention is associated with life threatening complications. In our setting, little is known on EOH.Objectives: To determine the prevalence, indications and outcomes of emergency obstetric hysterectomy while comparing both postpartum hysterectomy and caesarean hysterectomy.Methods: A 5-year hospital-based retrospective cohort study involving medical records of patients who underwent emergency obstetric hysterectomies between 1st January 2015 and 31st December 2019, was carried out at the Bafoussam Regional Hospital (BRH) from 1st February 2020 to 30th April 2020. Cases were classified as caesarean hysterectomy (CH) or postpartum hysterectomy (PH). Epidemiological data, indications, and complications of EOH were collected and analyzed in EPI-INFO 7.2.2.1. The chi-squared test was used to compare the two groups, and bivariate analysis was used to identify indicators of adverse outcomes of EOH. Statistical significance was set at p < 0.05.Results: There were 30 cases of emergency obstetric hysterectomy (24 caesarean hysterectomies and 6 postpartum hysterectomies), giving a prevalence rate of 3.75 per 1000 deliveries. The most common indication for CH, was intractable postpartum haemorrhage and uterine rupture (33.33% each), while abnormal placentation (50%) was commonly indicated for PH. Anaemia (both groups) (p = 0.013) and sepsis (PH group only, 33.33%) (p = 0.03) were the most statistically significant complications of EOH respectively. Absence of blood transfusion prior to surgery (p = 0.013) and prolonged surgery lasting 2 or more hours (p = 0.04), were significantly associated with a negative clinical outcome.Conclusion: The prevalence of EOH is high. There were no differences in the sociodemographic profile, risk factors and indications of both groups. PH group was more likely to develop sepsis as complication. Lack of blood transfusion prior to surgery and prolonged surgeries were significantly associated to complication. Meticulous care and timely recognition of negative prognostic factors of delivery as well as those of EOH will help improve maternal outcomes of pregnancy. [ABSTRACT FROM AUTHOR]

Background: Stillbirths bring grief to both mother and family but have been underreported in Cameroon. We aimed at determining the stillbirth rates and associated risk factors in the Buea Regional Hospital (BRH) and the Limbe Regional Hospital (LRH), Cameroon.Materials and Methods: This was a hospital-based unmatched case-control study in which files of women with stillbirth (cases) were analysed. A woman with a live birth in the same maternity during the same period served as a control. Data were collected using a pre-tested questionnaire. The stillbirth rate was the number of stillbirths per thousand births. Logistic regression analysis was used to identify independent factors associated with stillbirth.Results: Stillbirth rates at the BRH and LRH were 33.72 and 36.45 per 1000 live births. The factors that were independently associated with stillbirth were: referral status (AOR 3.95; 95% CI: 1.85-6.58, p = 0.000), late booking visit - after 12 weeks (AOR 13.64; 95% CI: 1.49-124.83, p = 0.021), preeclampsia (AOR 3.21; 95% CI: 1.23-8.35, p = 0.01), placental abruption (AOR 21.46; 95% CI: 2.36-194.77, p = 0.006), moderate anaemia (AOR 2.04; 95% CI: 1.09-3.83, p = 0.03), labour dystocia (AOR 5.37; 95% CI: 1.77-15.92, p = 0.003), low birth weight (AOR 5.27; 95% CI: 1.48-3.53, p = 0.000), and preterm delivery (AOR 2.81; 95% CI: 1.48-3.35, p = 0.002).Conclusion: Stillbirth rates are high in both health facilities. Risk factors of stillbirths include referral from another health facility, anaemia, preeclampsia and late booking visit, placental abruption, labour dystocia, preterm birth, and low birth weight. Term, post-term and macrosomia were protective of stillbirth. We recommend electronic data storage in hospitals in Cameroon. [ABSTRACT FROM AUTHOR]

Background: Postpartum febrile morbidity is relatively common, occurring in approximately 5-7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon.Methods: This was a 2 - year hospital - based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP.Results: A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p < 0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p < 0.001), and duration of labour > 18 h (OR 26.760, 95% CI: 7.100-100.862; p < 0.001) were the most significant risk factors associated with PP.Conclusion: Approximately 1 in every 12 postpartum cases in the DGH presents with PP. Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH. [ABSTRACT FROM AUTHOR]