Complications of Twin Delivery and Associated Factors: A Hospital-Based Cross-Sectional Analytical Study in Yaoundé

Background: Twin birth is considered a high-risk obstetrical situation. Despite the progress in obstetrical and pediatric care that has occurred in recent years, twin delivery is still associated with high maternal morbidity and perinatal mortality. Few recent studies have focused on the complications and risk factors associated with complications of twin birth in our environment. The objective of our study was to identify the complications of twin birth and the factors associated with them. Methodology: We carried out a cross-sectional analytical study. Data collection was prospective, over a period of 4 months (January 1, 2022 to April 30, 2022), at the maternity units of the Gyneco-Obstetric and Pediatric Hospital of Yaoundé and the Central Hospital of Yaoundé. The study population included all pregnant women who gave birth to twins during our study period at these hospitals. Data analysis was done using the SPSS software (Statistical Package for the Social Sciences) version 23.0. The Chi-square test was used to compare proportions and the student’s t test to compare means. A p-value of less than 0.05 was considered statistically significant. Results: In total, we recorded 37 complicated twin deliveries out of a total of 66 twin deliveries. This corresponded to a complication rate of 56%. Maternal complications occurred in 11.38% of cases, the majority being soft tissue lesions (4.54%), and postpartum hemorrhage (4.54%). Perinatal complications at the time of delivery were dominated by early neonatal infections (12.12%), non-reassuring fetal condition (10.6%) and intrauterine fetal death (6.06%). Factors associated with complications of twin births after univariate analysis were: maternal age ≤ 30 years (OR = 8.15;CI = 9.78 - 71.06;P = 0.03), being a student, (OR = 5.09;CI = 3.65 - 7.10;P = 0.00), primary level of education (OR = 1.48;CI = 3.30 - 6.63;P = 0.00), having less than four prenatal contacts (OR = 5.76;CI = 12.2 - 27, 24;P = 0.02), lack of ultrasound assessments (OR = 2.65;CI = 1.08 - 4.65, P = 0.04), diagnosis of twinning at labor (P = 0.03), admission for preeclampsia and eclampsia (OR = 2.01;CI = 1.24 - 5.9;P = 0.04), qualification of birth attendant as midwife (OR = 2.33;CI = 6, 38 - 8.50;P = 0.00), delivery time greater than 15 minutes for the second twin (OR = 2.45;CI = 1.14 - 5.26;P = 0.019). Conclusion: twin birth remains associated with high maternal and neonatal morbidity in our environment. The rate of maternal-fetal complications is 56% in our series. Post-partum hemorrhage, soft tissue injury and early neonatal infections are the main complications. These are closely linked to a number of factors whose control would improve the prognosis of twin birth.

Factors Associated with Maternal and Perinatal Complications of Preeclampsia at the Central Hospital of Yaoundé: A Cross-Sectional Analytical Study

Introduction: Pre-eclampsia (PE) is a public health problem especially in developing countries due to its incidence and severity. It is responsible for high maternal and perinatal morbidity and mortality. Accordingly, the objective of this work was to study the factors associated with the occurrence of maternal and perinatal complications of preeclampsia. Method: This was an analytical cross-sectional study with prospective and retrospective data collection including all patients, pregnant or postpartum, admitted for pre-eclampsia to the maternity ward of the Yaoundé Central Hospital. It took place over a period of seven (07) months. The data collected was analyzed using CS Pro 7.4, SPSS 20.0 and Microsoft Office Excel 2010 software. We compared the group with complications to the group without complications. We calculated the odds ratio to look for associations between variables and their 95% confidence intervals. The threshold for statistical significance was set at p Results: We recruited 214 cases of preeclampsia in our series. There were maternal complications in 44.4% of cases, dominated by eclampsia (31.8%). We recorded 07 maternal deaths, representing a maternal lethality of 3.3%. We had at least one perinatal complication in 105 cases (49.1%). The predominant perinatal complication was prematurity. We recorded 32 cases of intrauterine fetal demise and 13 cases of early neonatal death, giving a perinatal lethality of 21%. After logistic regression, the factors associated with maternal complications were residing in a rural area (OR = 2.217 [1.054 - 3.09];p < 0.036);a nurse-aid as prenatal consultation provider (PNC) (OR = 5.059 [2.175 - 36.162];p - 4.029]). Conclusion: Complications of preeclampsia are very common in our setting. Several identified factors are associated with the occurrence of these complications. We suggest building the capacity of providers of PNC and sensitization of women on the use of PNC services.

Excessive Weight Gain during Pregnancy and Prognosis of Childbirth in Douala (Cameroun)

The objective was to describe the maternofetal outcome of childbirth in women with excessive weight gain during pregnancy. We conducted a cross-sectional analytical study over a period of 03 months in the Obstetrics Department of Laquintinie Hospital in Douala (HLD). Our study population consisted of any pregnant in labor or waiting for a caesarean section. We compared two groups of pregnant women with excessive weight gain during pregnancy (exposed) and those without excessive weight gain during pregnancy (unexposed). We recorded 240 pregnant women who gave birth at the HLD maternity, 59 of whom had excessive weight gain during pregnancy, which gave us a proportion of 24.6%. The only sociodemographic characteristic associated with excessive weight gain during pregnancy was the married marital status of the pregnant women (OR: 2.0 (1.1 - 3.8) P = 0.023). Pregnant women with maternal complications associated with excessive weight gain had an average elevated uterine height of 35.4 (P = 0.007). The increase in caesarean section rate (P = 0.094) and the onset of pregnancy-related hypertension (HTA) showed differences close to significance (P = 0.063). Mean birth weight was higher (P = 0.023) in pregnant women with excessive weight gain during pregnancy. Ultimately, excessive weight gain during pregnancy has deleterious effects on the course of pregnancy and childbirth. It promotes the onset of pregnancy HTA and macrosomia.

Neurodevelopmental Problems in Children at 9 Months of Age Associated with Neonatal Hypoxic-Ischemic Encephalopathy

Introduction: Neonatal asphyxia is a major cause of infant morbidity in Cameroon. The aim of this study was to describe the short-term neurological outcome of children following neonatal Hypoxic-ischemic encephalopathy (HIE). Methodology: We conducted a retrospective cohort study from May 2010 to September 2013. We included 39 exposed cases against 78 non-exposed cases followed-up for at least 9 months. The variables studied were: age, sex, head circumference, neurological sequelae, postural anomalies and motor skills and developmental age/quotient. The data collected were analyzed using Epi info software version 3.5.3. The Fisher Exact Test was used to compare the variables with a significance threshold defined for p Results: We recruited 39 cases for 78 controls. The majority (74.40%) of cases were classified as HIE Sarnat 3 and 25.60% Sarnat 2. Most of the children were aged 12 - 36 months with a mean age of 18 months. The male sex was predominant with a sex ratio of 1.2;and 61.50% of children with HIE had head circumference Conclusion: The frequency of neurological sequelae following HIE was high in our series. Efforts should be made to prevent perinatal asphyxia and to ensure the availability of material and staff trained to help babies’ breath in all the delivery rooms in our maternities.