Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesa...Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p < 0.001), the persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001), Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p < 0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease (RR = 2.93, p Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications.展开更多
Introduction: The prevalence of HIV infection amongst pregnant women in Cameroon is 5.6%. Mother-to-child transmission is a major expansion factor. In 2010, Cameroon adopted new strategies pegged to WHO guidelines. Ob...Introduction: The prevalence of HIV infection amongst pregnant women in Cameroon is 5.6%. Mother-to-child transmission is a major expansion factor. In 2010, Cameroon adopted new strategies pegged to WHO guidelines. Objectives: The objective of this study was to evaluate the implementation of the new guidelines of prevention of mother to-child transmission (PMTCT) of HIV in the Yaoundé Central Hospital and the Yaoundé Teaching Hospital. Methodology: It was a cross sectional descriptive and prospective study over a period of 6 months in Yaoundé. It included all HIV-positive women, doing their antenatal care in the above cited hospitals, and having given their consent. The studied variables included socio demographic features, obstetrical history, the antenatal care, the initiation of anti retroviral (ARV) drugs, the ARV regimen, the number of years on ARV drugs, the mode of delivery and the mother and child outcome. The data was collected using a pre-tested questionnaire. They were obtained by interview of the seropositive pregnant women. Data were analysed using Epi info 3.5.3. Results: We performed 3104 antenatal consultations and 287 women were recruited in the study. The prevalence of HIV infection was 9.24%. The mean age of women was 28.77 (SD: 5.13) years. The women were aged between 20 and 29 years in 51.20%. Amongst the 156 women who knew their status before pregnancy, 109 (70.50%) had their first ANC in the first trimester. All were managed according to the 2010 WHO recommendations on PMTCT of HIV. Amongst the women unaware of their status, 25.20% had their booking ANC in the first trimester, 25.14% started ARVs at 14 weeks, 69.46% at 28 weeks. We had 125 live births, 84.8% by vaginal route, neonatal prophylaxis in all babies was effective. Conclusion: PMTCT of HIV is available and guidelines are well applied in Yaoundé. Late treatment initiation still remains a problem to optimize care.展开更多
Introduction: Informed consent is a process that enshrines respect for patients’ autonomy, their dignity, and their rights to determine what happens to their own bodies. We set out to describe the surgical informed c...Introduction: Informed consent is a process that enshrines respect for patients’ autonomy, their dignity, and their rights to determine what happens to their own bodies. We set out to describe the surgical informed consent process and evaluate its quality in patients undergoing elective gynaecological surgeries in two University Teaching Hospitals in Yaounde, Cameroon. Methods: This was a cross-sectional, prospective study over 9 month period, from October 1<sup>st</sup>, 2018, to June 30<sup>th</sup>, 2019 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH). By administering a modified Brezis questionnaire 48 hours after surgery, we obtained data which enabled us to evaluate and score the informed consent process and obtained written reports of patients’ appreciation of key aspects of the informed consent process prior to surgery. We then called each participant 6 months after their surgery date to obtain information on the occurrence or not of post-operative complications. Results: We recruited 72 patients aged 24 to 68 years old (61 at YGOPH, 11 at YCH). The operating gynaecologist sought patient consent in 65.3% (49/72) of cases, while 61.1% (44/72) of the subjects would have loved to have more information on surgical risks;69.4% (50/72) were satisfied with the consent process;and 56.9% (41/72) could recall and repeat the information they received prior to surgery. While 37.5% (27/72) had poor quality (non-valid consent), 40.3% had good quality consent (valid). Consent administered by the gynaecologist (OR = 0.172;95% CI = 0.060 - 0.049) was a strong determinant of valid consent. Also, patients with non-valid consent significantly reported more complications (OR = 4.469;95% CI = 1.412 - 14.147) than those with valid consent. Conclusion: Informed consent prior to elective gynaecological surgeries in our study was poor. The timing of the consent process, as well as the person involved in the process affect the validity of the consent.展开更多
文摘Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p < 0.001), the persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001), Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p < 0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease (RR = 2.93, p Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications.
文摘Introduction: The prevalence of HIV infection amongst pregnant women in Cameroon is 5.6%. Mother-to-child transmission is a major expansion factor. In 2010, Cameroon adopted new strategies pegged to WHO guidelines. Objectives: The objective of this study was to evaluate the implementation of the new guidelines of prevention of mother to-child transmission (PMTCT) of HIV in the Yaoundé Central Hospital and the Yaoundé Teaching Hospital. Methodology: It was a cross sectional descriptive and prospective study over a period of 6 months in Yaoundé. It included all HIV-positive women, doing their antenatal care in the above cited hospitals, and having given their consent. The studied variables included socio demographic features, obstetrical history, the antenatal care, the initiation of anti retroviral (ARV) drugs, the ARV regimen, the number of years on ARV drugs, the mode of delivery and the mother and child outcome. The data was collected using a pre-tested questionnaire. They were obtained by interview of the seropositive pregnant women. Data were analysed using Epi info 3.5.3. Results: We performed 3104 antenatal consultations and 287 women were recruited in the study. The prevalence of HIV infection was 9.24%. The mean age of women was 28.77 (SD: 5.13) years. The women were aged between 20 and 29 years in 51.20%. Amongst the 156 women who knew their status before pregnancy, 109 (70.50%) had their first ANC in the first trimester. All were managed according to the 2010 WHO recommendations on PMTCT of HIV. Amongst the women unaware of their status, 25.20% had their booking ANC in the first trimester, 25.14% started ARVs at 14 weeks, 69.46% at 28 weeks. We had 125 live births, 84.8% by vaginal route, neonatal prophylaxis in all babies was effective. Conclusion: PMTCT of HIV is available and guidelines are well applied in Yaoundé. Late treatment initiation still remains a problem to optimize care.
文摘Introduction: Informed consent is a process that enshrines respect for patients’ autonomy, their dignity, and their rights to determine what happens to their own bodies. We set out to describe the surgical informed consent process and evaluate its quality in patients undergoing elective gynaecological surgeries in two University Teaching Hospitals in Yaounde, Cameroon. Methods: This was a cross-sectional, prospective study over 9 month period, from October 1<sup>st</sup>, 2018, to June 30<sup>th</sup>, 2019 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH). By administering a modified Brezis questionnaire 48 hours after surgery, we obtained data which enabled us to evaluate and score the informed consent process and obtained written reports of patients’ appreciation of key aspects of the informed consent process prior to surgery. We then called each participant 6 months after their surgery date to obtain information on the occurrence or not of post-operative complications. Results: We recruited 72 patients aged 24 to 68 years old (61 at YGOPH, 11 at YCH). The operating gynaecologist sought patient consent in 65.3% (49/72) of cases, while 61.1% (44/72) of the subjects would have loved to have more information on surgical risks;69.4% (50/72) were satisfied with the consent process;and 56.9% (41/72) could recall and repeat the information they received prior to surgery. While 37.5% (27/72) had poor quality (non-valid consent), 40.3% had good quality consent (valid). Consent administered by the gynaecologist (OR = 0.172;95% CI = 0.060 - 0.049) was a strong determinant of valid consent. Also, patients with non-valid consent significantly reported more complications (OR = 4.469;95% CI = 1.412 - 14.147) than those with valid consent. Conclusion: Informed consent prior to elective gynaecological surgeries in our study was poor. The timing of the consent process, as well as the person involved in the process affect the validity of the consent.
