Introduction: Postpartum Depression is one of the commonest complications of the postpartum period. In Cameroon, little is known about this condition. Our objective was to determine the prevalence and identify the risk factors for postpartum depression. Methodology: The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, from November 4th 2013 to April 4th 2014. All the women between the 4th and 6th week after birth who gave their consent were included. A pretested questionnaire including demographic, psychosocial, maternal and infant variables as well as the Edinburgh Postnatal Depression Scale (EPDS) was filled. A woman with an EPDS score ≥12 was considered having postpartum depression, while a score < 12 ruled out a postpartum depression. Results: We recruited 214 women, among whom 50 had an EPDS score ≥ 12, giving a prevalence of 23.4% of postpartum depression. After multivariate analysis, the risk factors of postpartum depression were: lack of satisfaction in the marital relationship, recent financial problems, recent conflicts with the partner, baby blues, difficulties in feeding the baby and problems with the baby's sleep. Conclusion: Postpartum depression is common and associated to specific risk factors in our setting.
BackgroundCongenital uterine anomalies like bicornis or bicornuate uterus are relatively rare in sub-Saharan Africa. They are associated with an increased rate of spontaneous abortion, preterm delivery, and infertility. The occurrence of bicornis bicollis uterus with unilateral cervical atresia is exceptional and its management is controversial. We hereby report a rare cause of chronic pelvic pain in a Cameroonian teenager due to unilateral obstructive hematometra and hematosalpinx in the non-communicating horn of a bicornis bicollis uterus.Case presentationA 13-year-old premenarchal non-virgin female presented with chronic and severe cyclical crampy pelvic pain. On clinical examination, she had a perforated hymen, a single vagina, and one uterine cervix. A two-dimensional pelvic ultrasonography revealed hematometra but missed out the underlying anomaly. Failure to drain the hematometra by serial cervical dilatations prompted an exploratory laparotomy which revealed: bicornis bicollis uterus with a right rudimentary uterine horn communicating with the vagina and a left non-communicating uterine horn distended by hematometra due to a homolateral cervical atresia. She underwent utero-vaginal canalization and a left hemi-hysterotomy with drainage of the hematometra. The postoperative period was uneventful. Regular cyclic menses occurred thereafter beginning at the first postoperative month. She had complete resolution of symptoms without recurrence after six months.ConclusionDue to the risk of compromised fertility from bicornis uterus and the diagnostic challenges akin to resource-limited settings, we highlight the need for a high index of suspicion by healthcare providers when faced with chronic pelvic pain in premenarchal adolescents.
Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer's exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recHow to cite this paper: Dohbit, J.S., Mah, E.M., Essiben, F., Nzene, E.M., Meka, E.U.N., Foumane, P., Tochie, J.N., Kadia, B.M., Elong, F.A. and Nana, P.N. (2018 ) and prolonged labor (RR = 3 p < 10 −4 ). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnormalities, low Apgar score at the 5 th minute, need for neonatal resuscitation, neonatal asphyxia and neonatal infection which were significantly higher in the MSAF group (all p < 0.05). Meconium aspiration syndrome (MAS) was found in 2.34% of MSAF cases. Perinatal mortality was 2.34% and all cases of death occurred in the thick MSAF group. Conclusion: MSAF observed during labour is associated with increased perinatal morbidity and mortality. Its detection during labor should strongly indicate very rigorous intra partum and postpartum monitoring. This will ensure optimal management and reduction in the risks of complications.
Objective To evaluate maternal and perinatal outcomes in cases of third‐trimester malaria (TTM). Methods A parity‐matched comparative cohort study was carried out between December 1, 2018, and April 30, 2019, in three university teaching hospitals in Yaoundé (Cameroon). Women with and without TTM were followed up till delivery. The variables analyzed included maternal and gestational ages at delivery, the regimen of intermittent preventive treatment, usage of insecticide‐treated net, history of malaria recorded during pregnancy, birth and placenta weights, Apgar score, and early neonatal outcomes. Fisher exact test, t‐test, and logistic regression were used for comparison. P<0.05 was considered statistically significant. Results Of 3063 pregnant women, 130 (4.2%) had TTM. Adverse outcomes associated with TTM were maternal anemia (relative risk [RR] 10, 95% confidence interval [CI] 4.91–20.34), intrauterine fetal demise (RR 7.50, 95% CI 1.47–38.06), preterm delivery (RR 4.50, 95% CI 2.37–8.51), low birth weight (adjusted RR 2.88, 95% CI 1.34–6.19), neonatal asphyxia especially if delivery occurred during parenteral treatment (RR 5.18, 95% CI 2.56–10.48), transfer of the newborn to the neonatal intensive care unit (RR 4.38, 95% CI 2.59–7.42), and intrapartum or early neonatal death (RR 4.18, 95% CI 1.48–11.74). Conclusion TTM was associated with adverse perinatal outcome especially if labor started during parenteral treatment.
BackgroundUterine fibroids are the most common uterine tumours in females of reproductive age. During pregnancy, uterine fibroids may be complicated by aseptic necrobiosis. We herein report an ambiguous clinical presentation of uterine fibroids in pregnancy and discuss the diagnostic challenges encountered in our resource-constraint setting.Case presentationA term pregnant Cameroonian woman was admitted to our maternity unit with clinical findings suggestive of a strangulated umbilical hernia. She underwent an emergency caesarean section which fortuitously revealed aseptic necrobiosis of a uterine fibroid, managed within the same surgical intervention by myomectomy. Her post-operative course was uneventful.ConclusionThe authors highlight the need for a high index of suspicion by healthcare providers, as well as the need for a multidisciplinary approach for a favourable maternal and foetal outcome.
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