The impact of sexual activity during the third trimester of pregnancy on labor outcome in nulliparous women

Background: In the environment, there’s not enough studies on the effects of sexual activity during pregnancy on labor outcome, especially for nulliparous women. The aim was to assess the effects of sexual activity during the third term of pregnancy on the outcome of labor in nulliparous women.Methods: A prospective cohort study on labor was carried out for 11 months at the labor ward of the Yaoundé gynaeco-obstetric and pediatric Hospital. In this study compared women were exposed to at least one unprotected sexual intercourse with vaginal ejaculation per week during the third trimester of pregnancy (exposed group), to those who had less than one unprotected sexual intercourse per week (non-exposed group).Results: Of the 1123 primiparous women who gave birth within the study period, 426 consented to enroll in the study. Amongst these women, 186 women in the exposed group compared to 240 women in the non-exposed group. Intercourse during pregnancy predisposed on arrival into the labor ward to a Bishop’s score ≥7 (RR = 1.94; CI = 1.63-2.3) and within the course of labor to a spontaneous per vaginal delivery (RR = 1.18; CI = 1.06-1.31) and an active phase duration <6 hours (RR = 1.52; CI = 1.36-1.7). Furthermore, sexual intercourse during pregnancy protected against labor induction (RR = 0.21; CI = 0.12-0.36), dystocia (RR = 0.36; CI =  0.27-0.49), cesarean section (RR = 0.29; CI = 0.15-0.55), episiotomy (RR = 0.56; CI = 0.36-0.87) and an Apgar  score <7 at the first minute of birth (RR = 0.31; CI = 0.14-0.7).Conclusions: Sexual activity during pregnancy improves the prognosis of labor in primiparous women. In the absence of contraindications, consented unprotected heterosexual vaginal intercourse should be promoted in nulliparous women.

Factors associated with breast cancer occurrence before the age of 40 in Yaoundé

Background: In Cameroon, one third of breast cancers concern women less than 40 of age and young age appeared to be an independent predictor of adverse outcome. This study aimed to determine factors associated with the development of breast cancer before the age of 40 in Yaoundé.Methods: A case-control study was conducted for 7 months, from November 1st, 2016 to May 31st, 2017 at the General Hospital and the gyneco-obstetric and Paediatric Hospital of Yaoundé. Study compared the socio-demographic, clinical and lifestyle data of 50 women less than 40 of age with breast cancer (cases) with those of 200 women below 40 of age without breast cancer (controls). Descriptive statistics, bivariate and multivariate logistic regressions were performed to assess the socio-demographic, clinical and lifestyle data. Data were computed using the SPSS version 23.0 software. The significance threshold value was set at 0.05.Results: After multivariate analysis, the factors independently associated with the occurrence of breast cancer before the age of 40 were: age ≥ 30 (aOR = 2.05); family history of breast cancer (aOR = 8.65); parity ≥ 1 (aOR = 2.46); breastfeeding (aOR = 3.39); waist circumference ≥ 88 centimeters (cm) (aOR = 4.38); breast density ≥ 90                      (aOR = 2.89); physical activity ≤ 3 hours/week (aOR = 4.78). Conclusions: Breast cancer in women under 40 is associated with family history, reproductive life and women's lifestyles.  Breastfeeding more than 12 months, having a balanced diet, supplementary screening tests in women with dense breasts and practicing physical activity; would be  effective ways to prevent it in young women.

Pronostic des références obstétricales à l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY)

Introduction: l'impact des références sur la survenue des complications obstétricales n'est pas encore connu. Notre but était d'identifier les complications associées aux références obstétricales à Yaoundé.Méthodes: il s'agissait d'une étude transversale descriptive et analytique du 1er Février au 31 Juillet 2015 à l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé, ayant comparé les femmes référées aux non référées et leurs nouveau-nés respectifs. L'échantillonnage était consécutif et exhaustif pour l'analyse des caractéristiques sociodémographiques, obstétricales et néonatales précoces. Les tests de Chi carré et exact de Fisher ont aidé à comparer les variables qualitatives. L'analyse par régression logistique a permis d'éliminer les facteurs confondants. P était significatif si p < 0,05.Résultats: après analyse multi variée, les complications obstétricales statistiquement significatives chez les patientes référées étaient: la rupture prématurée des membranes (OR ajusté = 9,37, IC95%: 2,52-66,98, p = 0,002); la prématurité (OR ajusté = 4,14 (1,88-9,16; P < 0,001) et le décès après asphyxie néonatale sévère (OR ajusté = 6,48 (1,17-35,80); P = 0,032).Conclusion: la rupture prématurée des membranes, la prématurité et le décès après asphyxie néonatale sévère sont les complications associées aux références obstétricales à Yaoundé

Blood Uric Acid Level as a Marker of Increased Risk of Eclampsia in Severe Pre-Eclamptic Patients: A Cross-Sectionnal Study in two Tertiary Hospitals in Yaounde; Cameroon

BACKGROUND. Eclampsia is the most dangerous maternal complication in hypertensive disorders of pregnancy (HDP). Hyperuricemia is a sign of poor prognosis for both the mother and the fetus. We investigated the relationship between uricemia and the occurrence of eclampsia in cases of severe pre-eclampsia.MATERIALS AND METHODS. This was a three-month' cross-sectional study carried out in two tertiary hospitals in the city of Yaounde; Cameroon. All patients attending the hospitals with evidence of severe pre-eclampsia or eclampsia and willing to participate in the study were enrolled. Socio-epidemiology data and blood were collected as soon as the diagnosis was made; uricemia were measured using a spectrophotometric method. Statistical analyses were performed using SPSS 18.0 and significance was observed when P was 0.05.RESULTS. Ninety five pregnant women; aged between 15 to 41 years; with evidence of severe pre-eclampsia (60) or eclampsia (35) were enrolled during the months of January to march 2015. While age below 20 years increased the risk of eclampsia (OR

Etiologies de la mortalite maternelle a l'hopital gyneco-obstetrique et pediatrique de Yaounde: une serie de 58 deces

Objectifs: L'objectif de ce travail etait d'analyser les etiologies des deces maternels survenant dans un hopital de niveau tertiaire. Methodologie: Il s'agit d'une etude transversale avec collecte des donnees retrolective des deces maternels ayant eu lieu a l'Hopital Gyneco-Obstetrique et Pediatrique de Yaounde du 1er Janvier 2007 au 31 Decembre 2010. Tous les cas de deces maternels conformes a la definition de l'Organisation Mondiale de la Sante ont ete inclus. Les donnees ont ete analysees par les logiciels informatiques Epi info 3.5.1 et Excel 2007. Resultats: Cinquante-huit (58) deces maternels ont ete identifies pendant la periode de l'etude. Les principales causes de mortalite maternelle etaient : l'hypertension (22;4%); le VIH/SIDA (19;0%); les avortements septiques (17;2%); les hemorragies (13;8%); les cancers (10;3%) et la septicemie du post-partum (8;6%). Conclusion: L'hypertension; le VIH; et les avortements septiques sont les principales causes de mortalite dans cet hopital de niveau tertiaire. Les hemorragies ne sont responsables que d'une faible proportion des deces maternels. Nous recommandons la mise en place d'interventions visant a prevenir les deces maternels dus a l'hypertension en grossesse; a l'infection au VIH et aux avortements septiques. D'autre part; une politique hospitaliere basee sur la mise a disposition; sans frais exigibles en urgence; des paquets minimum pour les interventions obstetricales; de poches de sang et des equipes chirurgicales et anesthesiques; pourrait reduire efficacement la part des hemorragies dans la survenue des deces maternels en Afrique subsaharienne

Facteurs predisposant au traitement chirurgical dans la prise en charge de la pelviperitonite a Yaounde; Cameroun

Contexte et objectifs: Les facteurs d'echec de l'antibiotherapie en cas de pelviperitonite sont peu connus. L'objectif de cette etude etait de determiner les facteurs predisposant du traitement chirurgical dans la prise en charge de la pelviperitonite. Methodologie: Il s'agissait d'une etude cas-temoins avec collecte retrospective des donnees; concernant tous les cas de pelviperitonite traitees a l'Hopital Gyneco-Obstetrique et Pediatrique de Yaounde du 1er janvier 2007 au 31 decembre 2011. Resultats: Quatre-vingt-douze malades ont ete incluses; parmi lesquelles 75 patientes (75/92 ; 81;5) n'avaient recu que le traitement medical (groupe temoin) et dix-sept (17/92 ; 18;5) avaient necessite une prise en charge chirurgicale (groupe cas); soit une incidence de la chirurgie dans le traitement des pelviperitonites de 18;5. Les facteurs predisposant au traitement chirurgical etaient: un age 25 ans [P