A freaky motorbike accident causing vulvar hematoma: a case report at the Bafoussam Regional Hospital, West-Cameroon

Non-obstetric vulvar hematomas are rare and have never been reported in West Cameroon. No guidelines are available to inform the management of cases. Authors herein report the successful management of a post-traumatic vulvar hematoma in a 17 years old gravida 1 para 1001 patient. She was referred to our emergency department ten hours after a fall in a squatting position during a road traffic accident. Prior to the referral she had been managed conservatively by analgesics and a compressive dressing of the vulva in a community clinic. Clinical assessment on admission revealed a good general condition, normal vital signs and a tense and painful hematoma of the right labia. Surgery was done under general anesthesia to drain the hematoma, ligate the bleeding vessels and repair the vulva. Post-operative course was uneventful and the patient was discharge six days later. This case reminds practitioners in remote health facilities that early referral of this rare pathology contributes to its successful surgical management in our semi-urban region.

Dysmenorrhea among students in Yaounde, Cameroon: associated factors and socio-cultural aspects

Background: Dysmenorrhea is very common disorder. It affects the quality of life and is the main cause of school absenteeism’s among teenagers. The goal of this study was to determine socio-cultural aspects of dysmenorrhea among students in Yaounde and factors associated with it.Methods: Authors carried out a cross sectional analytic study in 2 secondary schools and a higher institute in Yaounde, from December 1, 2017 to June 30, 2018 (7 months). Authors included all students aged at least 15, in form 5 and above. In the higher institute, sampling was consecutive, while it was stratified into 2 clusters in the secondary schools.  Odds ratios were determined to assess association between variables and P-value ˂0.05 was considered significant.Results: Of the 1059 participants, 800 had dysmenorrhea (prevalence: 75.5%). Mean age was 18.88±3.62 years (range: 15-45 years). Family history of dysmenorrhea (OR: 4.20 (95% CI: 3.02-5.83)) and stress ((OR: 2.16 (95% CI: 1.55 - 3.02)) were significantly associated with dysmenorrhea. A duration of menses ≤3 days was protective ((OR: 0.31 (95% CI: 0.12-0.82)). Dysmenorrhea remains a taboo for 23.6% of participants.Conclusions: Family history of dysmenorrhea and stress are risk factors for dysmenorrhea which remains a taboo for almost a fourth of affected women. Authors recommend educating women about dysmenorrhea and control psycho-social stress.

Risk factors of intrauterine fetal death: a case control study at the maternity of Yaoundé Central Hospital

Background: Intrauterine fetal death (IUFD) is the death before the beginning of the work of the fetus from the 28th week of pregnancy or a fetus of weight greater than or equal to 1000g. It occurs in 98% in poor countries, particularly in sub-Saharan Africa. The aim of this study was to identify the risk factors for IUFD in low-income countries.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA-pulsatility index (PI) and UA-resistive index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI<2SD was taken as abnormal.Results: Independent risk factors for IUFD are age over 30 years (ORa = 2.1, P = 0.052), (ORa = 2.4497, p = 0.01), household occupation (ORa = 2.0097, p = 0.0282), hypertension disorders (ORa = 2.11, p = 0.0176), antepartal haemorrhage (ORa = 3.9635, p = 0.000), multiparity (ORa = 13.3089, p = 0.0056).Conclusions: The main risk factors for IUFD identified in our study are maternal age greater than 30 years, hypertension, antepartal haemorrhage, multiparity, and the household profession. Any pregnant woman who has one of these factors should be follow-up closely during pregnancy with a weekly assessment of fetal well-being by the 28th week.

Dysménorrhée chez les élèves et étudiantes à Yaoundé : facteurs associés et aspects socioculturels

Introduction.: la dysménorrhée est une situation fréquente chez les femmes en âge de procréer. Elle affecte la qualité de vie des filles et est la principale cause d'absentéismes scolaires chez les adolescentes. Notre étude avait pour objectif d'analyser les facteurs associés à la dysménorrhée et les aspects psychosociaux de la dysménorrhée chez les élèves et étudiantes à Yaoundé. Méthodologie. L'étude était transversale analytique, réalisée dans 2 établissements secondaires et un établissement supérieur de la ville de Yaoundé, du 1er Décembre 2017 au 30 Juin 2018 soit une durée de 6 mois. Étaient incluses toutes les élèves et étudiantes âgées de 15 ans et plus, ayant leurs menstruations et au moins un niveau d'instruction de la classe de seconde. L'échantillonnage était stratifié en grappe de 2 niveaux dans l'un des établissements et consécutif dans un autre. Le rapport de côte a été utilisé pour rechercher les associations entre les variables et la valeur P ˂ 0,05 était considérée significative. Résultats. Parmi les 1059 participantes, 800 avaient des dysménorrhées soit une prévalence de 75,5%. La moyenne d'âge était de 18,88 ± 3,62 ans avec des extrêmes allant de 15 à 45 ans. Les facteurs de risque de la dysménorrhée étaient : indépendamment associés aux dysménorrhées étaient les antécédents familiaux de dysménorrhée [OR (IC à 95%) : 4,20(3,02-5,83)] et le stress [OR (IC à 95%) : 2,16(1,55-3,02] ; tandis que la durée des règles ≤ 3 jours [OR (IC 95%) : 0,31(0,12-0,82)] est un facteur protecteur. La dysménorrhée était considérée comme un sujet tabou par 23,6 % des participantes. Conclusion. Les antécédents familiaux de dysménorrhée et le stress sont des facteurs de risque de la dysménorrhée. Certaines personnes affectées préfèrent ne pas en parler. Nous recommandons de sensibiliser les femmes sur la dysménorrhée et les aider à lutter contre le stress

Fetal Outcome of Deliveries among Teenagers in Centre Region of Cameroon.

Aims: In order to inform public health action, we sought to compare the fetal outcome of adolescent pregnancies with the non-adolescent ones. Study Design: Retrospective cross sectional study. Place and Duration of Study: Yaoundé Central Hospital, the largest facility of Centre Region (Cameroon) between May 2008 and March 2010. Methodology: A total of 6041 deliveries were compared using rates, proportions, means and OR, the fetal outcome of adolescent (10-19 years old) deliveries registered at the Yaoundé Central Hospital, to those in their non-adolescent counterparts. Results: Referred deliveries were significantly higher in adolescent participants compared to their non-adolescent counterparts (6.4% versus 4.3%, OR 1.53 95% CI 1.07-2.20). Non-adolescent pregnancies lasted significantly longer than adolescent pregnancies (38.46±2.72 versus 38.13±3.19 weeks respectively, p=.007). The former group had significantly higher rates of premature and post-term: deliveries (29.3% versus 24.5%, p=.041 OR 1.28 95% CI 1.01-1.62 and 4.9 versus 2.4%, p=.014 OR 2.11 95% CI 1.46-3.87 respectively). The rates of cesarean and assisted vaginal deliveries did not differ significantly between the 2 groups (16.6% versus 14.6%, p=.207 and 1.5% versus 1.1%, p=.411 respectively). Babies born of adolescent mothers weighed significantly less (irrespective of birth order) than those born of nonadolescent mothers (mean weights 2984.80±647.81 versus 3190.72±645.45 grams, p<.001). The odds of both apparent and perinatal deaths was significantly higher in the adolescent group (AOR 1.75, 95% CI 1.25-2.47 and AOR 1.69 95% CI 1.17-2.45 respectively). Conclusion: Adolescent pregnancies are associated with poor fetal outcome. There is need for counseling and provision of family planning services to reduce their incidence.