Profile of Full-Term Births in Maternity Wards of Public Hospitals in Douala Cameroon

Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.

Low Birth Weight in Cameroon: Research and Analysis of Factors Associated with Their Occurrence in Douala Maternity Wards

Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.

Draft of an Anthropometric Reference System for Full-Term Cameroonian Newborns: Prospective Study with Analytical Aim in the Maternity Wards of Douala

Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.

Hypercoagulability in the Context of Pre-Eclampsia: Case-Control Study at the Laquintinie Douala Hospital (Cameroon)

Introduction: Preeclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etio-pathogenesis involves, among other things, hypercoagulability, which alone accounts for about 15% of his deaths. Our objective was to study the parameters of coagulation (prothrombin level, activated cephalin time) in pregnant women with preeclampsia and non-preeclampsia at Laquintinie Hospital in Douala. Methodology: We carried out an analytical cross-sectional case-control study from November 01st, 2018 to May 31st, 2019, in the gynecology and obstetrics department of Laquintinie Hospital in Douala. We included preeclampsia and non-preeclampsia pregnant women with a gestational age greater than or equal to 20 weeks amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index, prothrombin level (PL) and activated cephalin time (ACT). Hypercoagulability was defined by the presence of at least one of the following abnormalities: PL > 100%, ACT < 25 seconds. Statistical tests were considered significant for a p-value < 0.05. Results: We recruited 150 pregnant women including 50 preeclampsia matched with 100 non-preeclampsia. The majority age group in both groups was 25 - 30 years (32% versus 37%). We found a high PL in 58% of preeclampsia versus 22% of non-preeclampsia patients (p = <0.001), a low PL in 8% of preeclampsia versus 0% in non-preeclampsia patients (p = 0.004). The ACT was prolonged in 12% of the preeclampsia versus 0% in the non-preeclampsia patients (p = <0.001). Pregnant women with preeclampsia were 4.89 times more likely to develop hypercoagulability than pregnant women without preeclampsia (OR 4.89;CI 2.34 - 10.20;p = <0.001). In linear regression, preeclampsia was significantly associated with PL (correlation coefficient 0.07;p = 0.008). We did not find risk factors associated with hypercoagulability in preeclampsia. Conclusion: Our study confirms the existence of hypercoagulability associated with preeclampsia, in particular in relation to an increase in the level of prothrombin.

Antibiotics Resistance of Urogenital Mycoplasma in Sexually Active Women Attending Gynecologic Consultation in Douala (Cameroon)

Introduction: Mycoplasmas are bacteria commonly found in the commensal flora of humans and can occasionally be pathogenic. The population and the geographical area determine their susceptibility to various antibiotics. Methodology: We carried out a cross-sectional study from January to June 2022 at the Douala General Hospital. All women who were sexually active and willing to participate were included. Endo-cervical swabbing was used to collect the samples. Culture and antibiotic susceptibility testing were performed in a liquid medium using Mycoplasma-SystemPlus Gallery (Liofilchem). All samples that degraded urea (threshold > 103 for Ureaplasma urealyticum) and arginine (threshold > 104 for Mycoplasma hominis) were deemed positive. Results: A total of 107 women with a median age of 33 ± 8.3 years and a predominance of 30-40 years (41.1%) were included. The frequency of mycoplasma infection was 73.8% with 34.1%, 11.4% and 54.4% for Ureaplasma urealyticum, Mycoplasma hominis and co-infection respectively. Resistance rates to Minocycline were low, 1.3% for Ureaplasma urealyticum and 3.7% for co-infection;for Pefloxacin the resistance rates were 3.7% (Ureaplasma urealyticum, Mycoplasma hominis) and 22.8% (co-infection). Ureaplasma urealyticum had a resistance rate of 3.7% for Erythromycin, 1.3% for Clarithromycin and 5% for Azithromycin. There was no significant correlation between risk factors and infection. Vaginal cleansing and the development of resistance in mycoplasma infection were found to be significantly correlated (OR = 6.915 [1.52 - 31.55];(p = 0.013)). Conclusion: Minocycline was the most active antibiotic and Ureaplasma urealyticum was the species with the lowest rate of resistance. Antibiotic resistance was more common in co-infected people than mono-infected. Antibiotic resistance was independently correlated with vaginal douching.