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The aim of this study is to evaluate the estrogenic effects of the methanolic extract of the stem bark of Cylicodiscus gabunensis in the female rat. The evaluation focused on the effect of the extract on the oestrous cycle, the evolution of the fresh weight of the uterus and ovaries, the total cholesterol level, and the total protein and oestradiol levels. The doses of extract administered to the female rats were 100, 200 and 400 mg/kg for 28 days. Administration of C. gabunensis extract at 400 mg/kg induced an increase in total protein levels. The administration of the extract at doses of 100 and 200 mg/kg gives the same results as the negative control which is distilled water. No significant variation of the C. gabunensis extract on the other parameters studied was observed compared to the negative control. This study shows that C. gabunensis would have anti-estrogenic effects, additional work should be carried out in order to validate the use of this extract in the treatment of female infertility.

Introduction: Pre-eclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etiopathogenesis involves, among other things, age, primi-gravidity, obesity, lack of sensitization to the partner's sperm. Objective: It was to describe the socio-clinical profile of the preeclampsia pregnant woman received in consultation in our service and to compare it with that of a control population. Methodology: We carried out a situational study of prospective descriptive and analytical type during 07 months from 01 November 2018 to May 31, 2019, in the obstetrics and gynecology department of the Laquintinie Hospital in Douala. We recruited in consultation a continuous series of 150 pregnant women including 50 preeclampsia that we matched to 100 non preeclampsia all at a gestational age greater than 20 weeks of amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index. The statistical tests were considered significant for a value of p˂0.05. Results: The preeclampsia pregnant woman in our series had a mean age of 27.80±5.80, mostly in the 25-30years, pauci-gravid, nulliparous and obese grade 1 with a gestational age predominantly ≥37 weeks of amenorrhea. This profile was non-exposing and heterogeneous compared to the control group of the same racial strain and to data from the literature. Conclusion: Our preliminary study suggests the existence of certain socio-clinical peculiarities in the preeclampsia pregnant woman in the black African environment.

Background: Neonatal mortality remains a major public health problem in low income countries. The survival within the first 28 days of life remains a challenge in such countries. Many strategies have been implemented to reduce deaths in children under five especially in sub-Saharan Africa. Laquintinie Douala Hospital benefits from some of these measures including a perinatal network and an emergency voucher. We aimed to describe the main causes of neonatal deaths at Laquintinie Douala Hospital. Methods: We carried out a cross-sectional study including files of all deceased neonates in the neonatal unit during a 24 months period from January 1st, 2017 to December 31st, 2018. Data collection included socio-demographic characteristics of the mothers and the newborns, clinical and therapeutic data and the evolution of the newborn. We used SPSS 20 software for data analysis with a p-value less than 0.05. Results: We included 270 files with an overall mortality rate of 13.1% and a sex ratio of 1.2. The main causes of death included prematurity (37.8%), neonatal infection (34.1%) and neonatal asphyxia (24.4%). The main factors associated with deaths included informal sector (OR = 5.49; 95% CI 0.86 - 34.77; p = 0.07) and a primary level of education for mothers, malaria during pregnancy (OR 2.28; 95% CI, 1.44 - 3.12; p = 0.0001), very preterm babies (OR 6.45; 95% CI 4.68 - 8.89; p 0.001) and resuscitation (OR 1.63; 95% CI 1.25 - 2.13; p = 0.0001). Conclusion: Neonatal mortality was lower than data in previous studies but remains high. This highlights the need for caregiver training and improvement of antenatal visits in our setting.

Introduction: The vaginal flora consists of bacilli of Doderleïn (various species of lactobacilli) which constitute a biofilm on the mucosa. These bacteria play a protective role by inhibiting the growth, adhesion or expansion of other microorganisms. To do this, various mechanisms are deployed, including the secretion of organic acids, antimicrobial substances, competition for nutrients and receptor sites as well as steric exclusion. This balance is sometimes called into question by the use of oral medications and antiseptics for vaginal cleansing, oral contraception, diseases such as the Human Immunodeficiency Virus (HIV) or diabetes. Objective: The objective of this work was to study the vaginal flora of women residing in the city of Douala. Methodology: we carried out in three health structures in the city of Douala a transverse analytical study for seven (7) months in women aged at least 21 years. We randomly included 540 women who gave their written and signed consent. The variables of interest were socio-demographic, clinical and microbiological variables. Gram staining was used and read using an optical microscope for the identification of microorganisms and the classification of flora consisting of bacteria from vaginal secretions. The statistical tests used for the comparison of the numbers were chi-square and the exact fisher test with a significance threshold of 5% (p

Introduction: According to the World Health Organization (WHO), adolescence is the period of growth between 10 and 19 years of age. Complications from pregnancy are the second leading cause of death for adolescent girls aged 15 to 19 worldwide. Objective: In order to reduce the phenomenon of early pregnancy, we set out to determine its prevalence as well as its outcome among adolescent girls in secondary schools in the Douala 3rd district in Cameroon. Methodology: To achieve our objective, we conducted an analytical case-control study from November 08, 2018 to June 26, 2019, in ten secondary establishments in the Douala 3rd district. Included in the study were all adolescent girls, students in one of the secondary schools in the said district who agreed to participate in the study. Data analysis was done using SPSS 20.0 software. The significance threshold was set at p 0.05. Results: A total of 445 adolescent girls were selected, including 89 cases and 356 controls. In 87.6% of the cases, the pregnancy was accidental and 58.4% used voluntary abortion. The univariate analysis of the results showed that the factor associated with the occurrence of teenage pregnancies was the age above 17 years (OR = 1.44; CI = 1.31 - 1.59) (p = 0.001). Conclusion: At the end of our study, it appeared that early pregnancies exist in Cameroonian schools with a high rate of 6.57% and an appeal to illegal abortion (62.9%).

Background: The breast cancer is an abnormal proliferation of mammary gland cells. This condition as well as other cancers is globally increasing in the world. It is the most frequent malignancy of women in the world and is a public health problem. Generally in Africa and central Africa in particular, few studies have been realized in search of risk factors of breast cancer. It’s all in this optical we began the study to determine the risk factors of this disease in the city of Douala. Patients and Methods: We conducted a case-control study, gave retrospectives collect on five years and prospectives collect on seven months. The studied population was all women aged 18 years and above with breast cancer diagnostic on histological plan for cases; and women from 18 years or more with normal physical examination and mammography. We have done our research in three reference hospitals of the city of Douala and two laboratories of pathological anatomy. The data were collected at the search files and the patients where interviewed. The parameters studied were: socio-demographic profile, clinic and Para clinic parameters, and the histological type. Results: At the end of this study, breast cancer is predominantly on young women in the city of Douala with a middle age of 44.08 ± 2.6 years. The most significant risk factors were age, age of the first birth ≥ 30 years, age of the first sexual act ≤ 18 years, low economic level, tobacco, hormonal contraceptive, parity. Conclusion: Finally, the malignancy of the breast takes a primordial place within the feminine population of Douala with many risk factors likes causes.

Background: Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and health expenditure. The burden of this condition has been understudied in Cameroon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Referral Hospital. Methods: We conducted an analytic matched case-control study of 206 pregnant women with evidence of urinary tract infection (103 cases) and those without (103 controls) who underwent antenatal care and gave birth at the DRH from January 2019 to April 2019. Socio-demographic, laboratory and maternal-fetal outcome data were collected using a pre-tested structured questionnaire and analyzed with SPSS version 23. Statistical significance was set at p Results: Escherichia coli (51.5%), Proteus mirabilis (15.5%), Staphylococcus aureus (11.7%) and Klebsiella sp. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1; 95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4; 95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6; 95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1; 95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13; 95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5; 95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. Conclusion: Escherichia coli was the main uropathogenic agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyelonephritis, preterm labor and delivery while fetal outcomes include: low-birth weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.

Les jumeaux conjoints sont une malformation rare des grossesses gémellaires monozygotes. Nous rapportons la découverte anténatale des jumeaux conjoints thoraco-omphalopages à 24 semaines d’aménorrhée. La patiente a bénéficié au préalable de 2 échographies par 2 praticiens différents qui n’ont pas pu détecter l’anomalie. La prise en charge a été multidisciplinaire une fois le diagnostic posé. Le pronostic foetal étant sombre dans ce cas et en raison de l’absence du plateau technique pour la prise en charge chirurgicale dans notre milieu, nous avons procédé (à la demande du couple) à une interruption médicale de la grossesse (IMG). Les données actuelles soutiennent que le diagnostic peut être fait plus précocement pour faciliter l’IMG quand elle est indiquée, d’où la nécessité de former ou recycler le personnel réalisant les échographies. Mots clés: Jumeaux conjoints, thoraco-omphalopage, diagnostic anténatal. English Abstract: Antenatal diagnosis of thoraco omphalopagus conjoint twins: a case studyConjoint twins are a rare defect in monozygotic twin pregnancies. We report the antenatal diagnosis of thoracoomphalopagus twins at 24 weeks gestation. The patient had previously undergone 2 ultrasounds by 2 different practitioners who were unable to detect the anomaly. The management was multidisciplinary once the diagnosis was made. The fetal prognosis being poor in this case and due to the lack of the equipment for surgical management in our setting, we proceeded at the couple's request for a Medical Termination of Pregnancy (MTP). Current data supports tthat diagnosis can be made earlier to facilitate MTP when indicated, hence the need for the training of personnel performing fetal ultrasounds. Keywords: Conjoint twins, thoraco omphalopagus, antenatal diagnosis

Introduction : La macrosomie foetale est définie par un poids de naissance supérieur ou égal à 4 000 g. La macrosomie foetale a fait l’objet de peu de publications dans la ville de Douala. Notre but était d’étudier les aspects épidémio-cliniques de la macrosomie foetale à l’Hôpital Général de Douala.Méthodologie : Nous avons mené une étude transversale analytique avec collecte rétrospective des données, au service de gynécologie-obstétrique de l’Hôpital Général de Douala. La période d’étude allait du 1er Janvier 2008 au 31 décembre 2012.notre population d’étude a été scindée en deux groupes. Le groupe 1 était constitué des nouveaux-nés macrosomes et leurs mères, et le groupe 2, des nouveaux-nés de poids inférieur à 4000g et leurs mères. Les dossiers incomplets ont été exclus. Nous avons effectué une analyse statistique unie variée pour l’étude des fréquences. Ensuite, nous avons comparé es données observées en utilisant le KHI DEUX. Le seuil de signification était de 1,96, et la marge d’erreur de 5%.Résultats : Nous avons inclus 5080 dossiers, dont 342 cas de macrosomes, soit une prévalence de 6,73 %. La macrosomie foetale survenait préférentiellement chez les patientes âgées de 30 à 35 ans, paucipares, aux antécédents d’accouchement de macrosomes, présentant un surpoids, plutôt qu’une obésité.Conclusion : La prévalence de la macrosomie à l’hôpital Général de Douala était de 6,73%. Cette étude a relevé des spécificités dans les facteurs pouvant accompagner la macrosomie foetale : l’âge maternel précoce (30 - 35 ans), et le surpoids plus fréquent que l’obésité. Ces données doivent être prises en compte, dans une approche proactive visant à réduire la prévalence de la macrosomie foetale et ses complications potentielles dans nos maternités : tel est notre challenge. Mots clés : macrosomie, aspects épidémio¬cliniques, Hôpital Général de Douala English Abstarct: Epidemiological and clinical aspects of foetal macrosomia at the Douala General HospitalIntroduction: Fetal macrosomia is defined as weight at birth greater than or equal to 4 000 g. There are very few studies on factors associated with foetal macrosomia in Cameroon. The objective of our study was to determine the epidemiological and clinical aspects of macrosomia in our area.Methodology: We conducted a comparative retrospective study at the Douala general hospital. It included women who had delivered from January 2008 to December 2012, divided in 2 groups, group 1 made of women with macrosomic baby at birth and in group 2 those without macrosomia. we used a single varied statistical analysis for prevalences, and Khi square to compare the values observed in the two groups evaluate associated factors.Results: Overall, 5080 mothers and their newborns were included. Among them 342 were macrosomic representing a prevalence of 6.73%. The main conditions observed with macrosomia were maternal age of 30 to 35 years, overweight, multiparity, gestational and pre gestational diabetes, finally past history of macrosomia.Conclusion: Prevalence of macrosomia in our hospital is high. The risks factors associated are classical, apart from a younger maternal age (30-35years), and overweight more frequent than obesity. Keywords: Prevalence-macrosomia- epidemiological and clinical aspects-Douala General Hospital

During pregnancy, the hematological system undergoes numerous changes so as to meet up with the demands of the developing fetus and placenta, with major alterations in blood volume and this differs with women from different regions. The aim of this study was therefore to assess the hematological parameters and risk factors for anemia among pregnant women according to different trimesters of pregnancy in Douala, Cameroon. Methods: A cross-sectional study was conducted from February to May 2017, and all pregnant women who attended antenatal visits during our study period and who suited our inclusion criteria were recruited. The study was carried out in the antenatal care Unit of the Douala Laquintinie Hospital (DLH). A pretested questionnaire was used for the necessary data collection. Venous blood was collected from each of these women to perform a Complete Blood Count (CBC) test using an automated hematological analyzer (URIT 3010). Data were analyzed using XLSTAT 2007 and Stata version 11 software. Results: The mean age of the participants was 28 (SD = 5 years). The prevalence of anemia among pregnant women was 22% with a majority (18.4%) of these women being mildly anemic. Mean Hemoglobin values were significantly higher among women in first trimester compared to the third (12.1 ± 0.9 g/dl vs 11.8 ± 1.3 g/dl; p = 0.043). There was also a significant change in mean hematocrit (HCT) values between the first and second trimester (32.8% ± 2.5% vs 31.4% ± 2.9%, p = 0.004) and between the first and third trimester (32.8% ± 2.5% vs 30.8% ± 3.5%, p -4). RBC count value was higher in the first trimester than in the second trimester (3.7 ± 0.3 × 1012/L vs 3.5 ± 0.4 × 1012/L, p -4) and in the third trimester (3.7 ± 0.3 × 1012/L vs 3.5 ± 0.4 × 1012/L, p = 0.001). After a multivariate analysis, the following categories of women had more odds of developing anemia; women between the age range of 30 - 35 (OR = 2.81, 95%CI: 1.16 - 6.81, p = 0.023), women in the second trimester of pregnancy (OR = 2.20, 95%CI: 0.88 - 5.48, p = 0.024), women with blood group O (OR = 3.57, 95%CI: 1.41 - 16.66, p = 0.012). Conclusion: This study confirms significant variations in hematological parameters. The findings reinforce the need for supplementation and provide additional information on hematological reference values in pregnancy in Cameroon. It also helps us understand that, third trimester, age range 30 - 35, and blood group may be potential risk factors associated with anemia in pregnancy though a cohort study would be necessary to ascertain this hypothesis.

Background: Quality control of care aims to reduce or eliminate unnecessary care and to improve the quality of those who are useful both in their indication and in their implementation. Objective: We conducted this study to assess the rate of caesarean section, the rate of irrelevant indications, materno-foetal morbidity and mortality, biases in the management in order to suggest corrective approaches. Methods: It was a cross-sectional study conducted in the gynaeco-obstetrics department of the Laquintinie Hospital of Douala over a period of 4 months from January 1 to April 30, 2017. We included all pregnant women who had a caesarean section and who gave consent to our study as well as new-borns from these caesareans. We excluded caesarean deliveries from other health structures and referred to Laquintinie Hospital due to morbid operative follow-up. The variables collected were grouped under 3 main headings: socio-demographic data, clinical data and post-operative follow-up. Results: A total of 281 caesarean sections were performed out of a total of 967 deliveries; a caesarean section rate of 29.06% in 4 months. After data mining, 250 caesarean sections were included in the study because 31 cases of caesarean deliveries were unusable. Referred pregnancies accounted for 46.8% of the total population and the most common reason for referral was stationary labour (23% of cases). All caesareans were performed by the gynaeco-obstetricians. Women who had caesarean deliveries were informed by the operator of the surgical procedure in 28.4% of cases and 27.6% were notified of the indication for surgery. The operative kit was present in 98% of cases. The operating room was available in 93% of cases. Caesareans were performed mostly in an emergency context (91.2%) with a median turnaround time of 214 minutes (3 h 56 mins). Mechanical dystocia was the major indication in our series (21.2%) and 29 indications were irrelevant (11.6%). Intraoperative complications occurred in 3.2% of cases. Overall maternal mortality (per- and post-operative) was 0.8% (2 cases). We recorded 15 neonatal deaths out of which 8 were still births. Regarding the postoperative period, 78% of the operated patients did not have a good immediate postoperative monitoring. The post-operative protocol was not respected in 17% of cases. Postoperative complications occurred in 21.6% of patients with first cause being infections (10.8% with 5.6% being parietal suppurations). Conclusion: The frequency of Caesarean sections at Laquintinie Hospital is above the World Health Organization’s recommendations of 5% - 15%. There is a very big delay in the execution time of emergency caesareans, far above the international standards despite the quasi-availability of operating kits and the operating theatre. The state of the premises reveals a sub-workforce creating work overload and therefore a demotivation of the staff leading to insufficient communication between the operator and operated, a lack of postoperative follow-up and significant neonatal morbidity and mortality. Hence the need to initiate a staff satisfaction survey.

Introduction: The use of traditional preparations for the induction or acceleration of labor remains a common practice in our country in particular and in Africa in general with sometimes derogatory outcomes for the mother and the fetus. Goal: The objective was to assess immediate maternal and neonatal outcomes in women who reported having used the traditional pharmacopoeia for utero-tonic purposes. Methodology: We conducted a multi-centric cross- sectional study with prospective data collection in the maternities of the Laquintinie Hospital, Bonassama District and Nylon Hospitals. It took place over a period of seven months, from 1st October 2016 to 31st April 2017. This included all women who reported having used the unconventional pharmacopoeia for utero-tonic purposes before or after contractions started. The student and Chi-square tests were interpreted at the statistical threshold of 5% and the 95% confidence intervals. Results: We recruited 168 cases, 68.5% of the 245 women interviewed. The mean age was 27.1 ± 0.41 years; 55% of our respondents had a secondary level of education; 80% of them were admitted at term and 43% were multiparous. Nulliparity predisposed to traditional pharmacopoeia use (RR = 1.55, CI = 0.79 - 3.03) but primiparity reduced this risk (RR = 0.4, CI = 0.24 - 0.926). Stimulation of labor was the first indication in 85% of women, the rectal evacuation enema was the main route used (67%). The majority of plants used were those of the families Asteraceae, Anthericaceae, and Malvaceae. In per partum, 42% had a brilliant dilatation; there was a statistically significant association between the occurrence of dynamic dystocia (CI = 0.28 - 1.54, p = 0.006) and the risk of perineal tear (RR = 3.13, CI = 1.68 - 5.85; p = 0.007). The APGAR score at 5 min of life was less than 7 in 64% of cases (p = 0.027). The caesarean section rate was 69%. Conclusion: Traditional products with uterotonic effects are frequently used and unregulated with its corollary of materno-fetal complications.

Introduction: The prevalence of cervical cancer in Cameroon is 80.73/100,000 women, with an estimated incidence of 40/100,000 women-years. It is a real public health problem. There is no systematic and effective screening program for cervical cancer in our country, despite the advent of visual tests that are simple to use, low cost, and adapted to the modest income of our social groups. Objectives: We aimed at determining the usefulness and place of visual tests in screening for cervical dysplasia and cervical cancer for its implementation at the Laquintinie Hospital Douala, Cameroon. Methods: We conducted a prospective analytic cross-sectional study of cervical dysplasia and cervical cancer screening by visual testing at the Laquintinie Hospital Douala from December 1, 2016 to March 31, 2017. Data collection was by consecutive non-probabilistic method and consenting sexually active women older than 21 years were enrolled for study. Data analysis was with Epi InfoTM version 7. Associations were done with the Chi square, student t-test and Fischer’s exact test where appropriate. Bivariate and multivariate analysis was done and reported as odd ratios, adjusted odd ratios and 95% confidence intervals. Statistical significance was set at P < 0.05. Results: We received 1590 women, of whom 1506 (94.7%) screened for dysplastic lesions and cervical cancer during the study period. The results obtained were: 1417 (94.1%) had a normal result; 64 (4.2%) had a positive visual test (TV+); and 25 (1.7%) visual tests were inconclusive (TV-nC). Of the 64 women whose visual tests were positive, 15 (23.5%) were HIV+. We performed 80 colposcopies and biopsies, including 61 women with positive visual tests and 19 non-conclusive visual tests. Among women with TV+, we found 06 cancers (squamous cell carcinoma: 05, adenocarcinoma: 01) and 05 dysplasias (CIN1: 04, CIN3: 01). Histological examination in women with TV-nC revealed 02 dysplasias (CIN1: 02). Half of the women with cervical cancer were HIV+. In our series, the prevalence of cervical dysplasia and cervical cancer was respectively 05 per 1000 women and 04 per 1000 women. The early onsets of sexual intercourse and co-infection with HIV were the main factors associated. Visual tests were very sensitive (84.62%), but with a relatively low specificity (25.37%). Conclusion: Visual tests prove to be a useful tool for mass screening of precancerous and cancerous lesions of the cervix in view of its sensitivity, cost and performance.

Introduction: According to the World Health Organization (WHO), adolescence is the period of growth between 10 and 19years of age. Complications from pregnancy are the second leading cause of death for adolescent girls aged 15 to 19 worldwide. Objective: Our objective was to study the sexual practices of adolescent girls in secondary schools in the Douala 3rd district as well as their contraceptive attitudes towards precocious pregnancies. Methodology: We conducted a case-control analytical study from November 8th, 2018 to June 26th, 2019 in ten secondary schools in the Douala 3rd district. We matched, around the obstetric variable, a case group with this history to a control group who declared not to have had one and studied the different strategies used to avoid the occurrence of pregnancy. Data analysis was done using SPSS 20.0 software. The significance threshold was set at p

Objective: To determine the impact of Human Immuno-Deficiency Virus (HIV) on co-infection with Mycoplasma hominis and Ureaplasma urealyticum in HIV-infected women. Methodology: A case-control analytical study based on standardized questionnaire interview and cervical sample collection after informed consent obtained among HIV-positive and HIV-negative women from January 2nd, 2017 to June 30th, 2017 received at the laboratory of Laquintinie Hospital in Douala. Samples collected were used for mycoplasma research, quantification, and antibiogram using the mycoplasma IES kits. Socio-demographic, clinical and biological variables of interest were entered and analyzed on Microsoft Office Excel 2013 and Statistical Package for Social Sciences (SSPS) software version 20 and the chi-square correlation test was used with significance at the threshold of P

The rate of uterine scars, an established risk factor for obstetric morbidity, is increasing worldwide. In developing countries, spontaneous uterine ruptures may constitute 87.4% of cases. Tratment is a problem in modern obstetrics, in particular in these countries. This study aims to describe healthcare chain and materno-fetal follow-up of post-partum women with uterine scar in three university hospitals in the city of Yaoundé in order to highlight morbidity management problems in low-resource countries at the dawn of sustainable development goals. We conducted a cross-sectional descriptive study based on the collection of prospective data over a period of six months in 2014. The study included all consenting post-partum women with uterine scar, having given birth to a gestational at a gestational age greater than or equal to a total of 28 weeks of amenorrhea. The sampling was consecutive and exhaustive. Chi square test statistic was applied in all research areas, with a reliability threshold of p≤ 0.05. Data on 252 women with uterine scars, reflecting a rate of 8% (252/3145), were collected during the study period. Prenatal consultations were performed by inadequate staff in an inadequate sanitary structure in 30% of cases. Women were referred due to delivery complications after first admission to an inadequate sanitary structure in 25% of cases (6 uterine ruptures and 7 dead fetus before admission). There was indication for cesarean section/laparotomy on admission in 39% of cases; the rate of vaginal delivery was of 23%; there was indication for trial of scar in 30% of cases, with a success rate of 76.3%. Vaginal delivery was related to parity, a history of vaginal delivery, fetal macrosomia and was inversely related to the number of scars. Maternal mortality was zero and cesarean section was related to materno-fetal morbidity. The poor quality of prenatal consultations and the management of delivery are the main determinants of problems during vaginal birth after cesarean section in our environment. The establishment of a system facilitating access to skilled health care practitioners/adequate health care facilities for pregnant women with uterine scar would improve the prognosis of post-partum women with uterine scar.Keywords: Uterine scae, healthcare chain, Yaoundé

Background: Pregnancy is the term used to describe the period in which a foetus develops in the uterus and lasts 40 weeks measured from the last menstrual period. Anatomic and physiologic changes in pregnant women usually make couples to change their emotional and sexual activities that may impact childbirth. There are few studies in our setting that describe the roles of sexual practice during pregnancy and maternal-foetal outcomes of childbirth.Objective of this study aimed at assessing the benefits of sexual practice during pregnancy in a target population and to assess the outcome.Methods: We carried out a comparative cross-sectional study from February 2018 to May 2018, at the maternity of Laquintinie Hospital in Douala. Socio-demographic, obstetric, sexual history in pregnancy, birth and neonatal data were collected using a structured questionnaire. Univariate and multivariate analyses were conducted at a 95% confidence interval.Results: A total of 300 respondents completed study and 69.6% were favourable to sexual intercourse during pregnancy. Induction or augmentation of labour was common in the unfavourable group [OR: 2.52 (1.53-4.15); p=0.004]. Almost one in two participants gave birth by caesarean section and the indications for caesarean section were similar in both groups. Participants without sexual intercourse in pregnancy had a 9-fold increased risk of perineal tears [OR: 8.99 (4.02-10.1); p=0.001] and 5.4-fold risk of cervical tears [OR: 5.44 (2.44-8.73); p=0.0001].Conclusions: Sexual practice in pregnancy appears to be protective against excessive use of oxytocin, perineal and cervical tears.

Le taux d'utérus cicatriciel, facteur de risque établi de la morbidité obstétricale augmente à travers le monde. Dans les pays en développement, les ruptures sur utérus non cicatriciel peuvent constituer 87,4% des cas. Sa prise en charge demeure ainsi une problématique de l'obstétrique moderne, notamment dans ces pays. L'objectif était de décrire le circuit de prise en charge et le devenir materno-fœtal des accouchées porteuses d'utérus cicatriciel dans trois hôpitaux universitaires de la ville de Yaoundé pour un état des lieux de la problématique de la prise en charge de cette morbidité grave dans les pays à faible ressources à l'aube des Objectifs pour le Développement Durable. Il s'agissait d'une étude descriptive, transversale avec collecte prospective des données, sur une période de six mois en 2014. Etaient inclues les accouchées consentantes, porteuse d'utérus cicatriciel, ayant accouché à un âge gestationnel supérieur ou égal à 28 semaines d'aménorrhée révolue. L'échantillonnage était consécutif et exhaustif. Chi carré a été le test utilisé statistiquement, P≤ 0,05 étant le seuil de fiabilité. Nous avons recruté 252 cas d'utérus cicatriciel, soit une fréquence de 8% (252/3145) pendant la période d'étude.30% avaient des CPN réalisées par un personnel inadéquat dans une structure sanitaire non appropriée,25% étaient référées avec complications pendant le travail après une première admission dans une formation sanitaire inadéquate, dont les 6 cas de ruptures utérines et 7 fœtus décédés avant l'admission.39% avaient une indication de césarienne/laparotomie dès l'admission, le taux d'accouchement par voie basse était de 23% , l'épreuve utérine était indiquée chez 30%, avec un taux de réussite de 76,3% .L'accouchement par voie basse était corrélé à la parité, les antécédents d'accouchement par voie basse , la macrosomie fœtale et inversement corrélé au nombre de cicatrices .Le nombre de décès maternel était nul et l'accouchement par césarienne était corrélé aux morbidités materno-fœtales. La mauvaise qualité des CPN et de la prise en charge de l'accouchement demeurent les principaux déterminants de la problématique de l'accouchement sur utérus cicatriciel dans notre milieu. La mise en place d'un système facilitant l'accessibilité des femmes enceintes porteuses d'utérus cicatriciel aux prestataires/formations sanitaires adéquats permettrait d'améliorer le pronostic des accouchées porteuses d'utérus cicatriciel.

Introduction. Le placenta est un organe nourricier assurant un lien vital entre le fœtus et la mere. Les lesions placentaires ont des repercussions sur le developpement fœtal et peuvent expliquer l'hypotrophie. Objectif. Decrire les lesions anatomopathologiques des placentas des nouveaux nes hypotrophes observes en milieu hospitalier. Materiels et Methodes. Il s'agissait d'une etude prospective, transversale et analytique couvrant une periode de seize mois, du 1er juin 2010 au 31 octobre 2011. Le recrutement des placentas etait consecutif. L'examen anatomopathologique a ete effectue apres examen systematique des placentas. Resultats. Un echantillon de 140 placentas parmi lesquels 70 placentas issus des nouveaux nes hypotrophes ont ete apparies a 70 placentas des sujets normaux. Les placentas provenaient des femmes dont l'âge variait de 15 ans a 44 ans avec une moyenne de 27, 16±5, 91 ans. Les anomalies macroscopiques relevees dans les placentas des nouveaux nes hypotrophes comportaient 37,50 % d'insertion marginale et velamenteuse du cordon ainsi que 42,50 % de brachy-cordon. Les differences concernant l'insertion du cordon etaient statistiquement significatives (P). Les lesions histologiques etaient caracterisees par des villites, des intervillites, suivies des chorioamniotites, d'un exces de depots de fibrine, des amas trophoblastiques exuberants perivillositaires, de collapsus de la chambre intervilleuse, de necrose ischemique, de diminution de la taille des villosites et de la congestion des vaisseaux, soit au total 37,10 % des lesions. Par contre, seulement 20,10 % de lesions microscopiques etait retrouvee dans les placentas des nouveaux nes du groupe temoin, la difference dans les deux groupes etant statistiquement significative (P = , 039). Conclusion. Les placentas des nouveaux nes hypotrophes montrent plus frequemment une diversite de lesions macroscopiques et histologiques avec une nette predominance des villites et intervillites, compares aux placentas des nouveaux nes normaux.

Ectopic pregnancy is the leading cause of maternal mortality in the first trimester. When a patient is admitted before rupture, organ-preserving management which keeps a higher fertility rate than ablative surgery can be done. The incidence of Unruptured Ectopic Pregnancy (UTP) on admission is unknown. In the study facilities, methotrexate treatment was given to most of UTP regardless of Fernandez score. The aim of this study was therefore to assess the lessons learnt from that experience. Methods: It was a cross sectional study over a 10 years period, conducted in four university teaching hospitals affiliated to the University of Yaounde I, Cameroon. Included patients were managed either by therapeutic abstention, single or multidose intra muscular MTX. Onset of clinical acute abdomen was the only indication of failure of conservative management and prompted emergency laparotomy. Results: We included 153 UTP cases. The incidence of UTP on admission was 0.46%, the mean age 28.4 ± 4.9, 88.2% were admitted at a gestational age