Prune belly syndrome and associated malformations. A 13-year experience from a developing country

A retrospective investigation was conducted to describe clinical features and birth outcomes among babies with prune belly syndrome detected ante-natally and at birth at the University Teaching Hospital in Cameroon. A total of 11 cases were identified over a period of 13 years, and the majority of affected fetuses were male (10 of 11). Most of the mothers were less than 30 years of age, had singleton pregnancies, and about two-thirds were complicated by placenta praevia, genital infections, preeclampsia, and anaemia associated with hookworm infestations. The most prominent findings related to prune belly syndrome among our patients were clubfoot (45), pulmonary hypoplasia (27), Potter facies (27), imperforate anus (27), and arthrogryposis (18). About two-thirds of the affected pregnancies did not reach the age of viability either due to voluntary termination (three of seven cases) or spontaneous abortion (four of seven cases). Of the remaining four viable pregnancies, two cases each of stillbirth and neonatal death were recorded. Among pregnancies that were not voluntarily terminated (n = 8), multiple concomitant anomalies and bilateral renal lesions were apparently the cause of fetal/infant death in the majority of cases (75). In conclusion, Cameroonian babies with prune belly syndrome presented with clinical features that were comparable to those observed in developed nations

Effect of Chloroquine Prophylaxis on Birthweight and Malaria Parasite Load among pregnant women delivering in a regional hospital in Cameroon

This survey was conducted between December, 1997 and August, 1998 at the Chantal Biya Maternity Section of the Ebolowa Provincial Hospital, Cameroon. A total of 231 parturient mothers who gave birth to 232 neonates were included in the study. Ninety-five of them (41.1 percent) took anti-malaria prophylaxis (chroloquine) in the index pregnancy, and 136 (58.9 percent) did not. Both groups were similar with respect to socio-demographic characteristics except for educational level of the mother, which was significantly higher in the group on prophylaxis (x2 = 8.05; df = 2, p = 0.02). The overall prevalence of maternal parasitaemia was 37.2 percent. The group on chloroquine (TG) experienced a lesser parasitaemia (26.3 percent) than the non-prophylactic group (CG) (44.9 percent odds ratio (OR) = 2.28, CI = 1.24 - 4.19). The proportion of women with severe parasitaemia (>4000 parasites/ul) was also lower in the TG than CG (17.6 percent vs. 7.3 percent; OR = 2.69, CI = 1.04 - 7.23). A modest reduction in low birthweight was found in the TG which was not significant (23.4 percent vs 16.0 percent; p = 0.16). In conclusion, chloroquine given to prevent malaria in pregnancy was found to be effective in reducing peripheral malaria parasitaemia, but improvement in birthweight could not be demonstrated. Among other factors, impaired biological activity of the drug at the level of the placenta where parasite sequestration frequently occurs might be the explanation. We recommend that further investigation be carried out in the study area to evaluate this finding, and if confirmed, institute appropriate changes in the present policy of chloroquine prophylaxis in pregnancy.