Maternal mortality in Maroua Provincial Hospital, Cameroon (2003-2005)

Background: In September 2000, the Heads of States of the 191 countries of the United Nations approved the Millennium Declaration in which reduction of pregnancy-related deaths to a quarter by 2015 was one of its goals. However, before the middle of the first decade of this millennium, there were no reports on the status of maternal mortality in Maroua, Cameroon.Objective: The aim of this study was to establish baseline data on maternal mortality for future evaluation of pregnancy-related mortality trends in this city. Subjects and Methods: Maternal deaths that occurred from 2003 to 2005 in Maroua City, Cameroon,were analyzed. Mortality ratios were determined by comparing the number of the deaths related to pregnancy with that of women with safe deliveries. Mortality risks were determined by comparing the characteristics of women with pregnancy-related deaths to those of women with safe deliveries. Results: The overall maternal mortality ratio was 1266 maternal deaths per 100 000 live births. The leading causes of death were hypertension (17.5%), obstetric infections (14.3%), uterine rupture(14.3%), anaemia (12.7%) and HIV complications (9.5%). Among the women who died, 28.6% were teenagers and 14.3% were at their sixth delivery (or above). Compared with women aged 20 to 24 years, those aged 25 to 29 years were more than twice as likely to die from pregnancy-related causes (HR: 2.34; CI: 1.07,5.08; p = 0.029). A similar trend was also found in those aged 30 to 34 years (HR: 2.26; CI: 1.02,5.00; p = 0.042). Conclusion: The findings suggest that Maternal Mortality Ratio in Maroua, City, Cameroon, is veryhigh. Since most of the causes of death were preventable, we propose that the current maternal and Family Planning strategies be reviewed with the view to reducing the current trend. Such a strategy would enable the Maroua city to meet the Millennium goals by 2015.

Antecedentes: En septiembre del 2000, los Jefes de Estado de 191 países de la Naciones Unidas, aprobaron la Declaración del Milenio, una de cuyas metas es la reducción hasta una cuarta parte, de las muertes relacionadas con el embarazo, para el año 2015. Sin embargo, antes de mediados de la primera década de este milenio, no habia reportes sobre el estado de la mortalidad materna en Maroua, Camerún. Objetivo: El objetivo de este estudio fue establecer los datos preliminares comparativos de referenciasobre la mortalidad materna para la evaluación futura de las tendencias de la mortalidad en relación con el embarazo en esta ciudad. Sujetos y Métodos: Se analizaron las muertes maternas ocurridas del 2003 al 2005 en la ciudad de Maroua, Camerún. Las tasas de mortalidad fueron determinadas comparando el número de muertesrelacionadas con el embarazo, con el número de mujeres que tuvieron partos seguros. Los riesgos de mortalidad fueron determinados comparando las características de mujeres que murieron por causas asociadas al embarazo, con mujeres que tuvieron partos seguros. Resultados: La tasa general de mortalidad materna fue de 1266 muertes maternas por cada 100 000nacidos vivos. Las causas principales de muerte fueron: hipertensión (17.5%), infecciones obstétricas (14.3%), ruptura uterina (14.3%), anemia (12.7%) y complicaciones por VIH (9.5%). De las mujeres que murieron, 28.6% eran adolescentes y 14.3% estaban en su sexto parto (o por encima). En comparación con las mujeres de 20 a 24 años de edad, las de 25 a 29 años presentaban una probabilidad dos veces mayor de morir por causas relacionadas con el embarazo (HR: 2.34; CI: 1.07, 5.08; p =0.029). Una tendencia similar se halló también en las mujeres de 30 a 34 años de edad (HR: 2.26; CI: 1.02, 5.00; p = 0.042). Conclusión: Los hallazgos sugieren que la tasa de mortalidad maternal en la ciudad de Maroua,Camerún, es muy alta...

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

Regression spontanee de grossesse ectopique et fertilite: A propos d'un cas observe au cours d'une cystectomie

Les auteurs rapportent un cas de grossesse ectopique d'evolution regressive decouverte au cours d'une cystectomie par laparotomie. L'interrogation detaillee de la patiente montre les difficultes de diagnostic de grossesse ectopique dans le contexte d' un pays en developpement ou les infrastructures medicales sont encore peu developpees. En se referant a la litterature; les auteurs indiquent la possibilite de regression de certains cas de grossesse ectopique. Ils insistent sur l'amelioration des infrastructures medicales au Cameroun; ce qui devrait permettre d'integrer l'echographie endovaginale et le dosage de Beta HCG dans le diagnostic precoce de la grossesse ectopique