[Risk factors and prognosis of emergency cesarean delivery at the Yaoundé Women's and Children's Hospital, Cameroon]. / Facteurs de risque et pronostic des césariennes d'urgence à l'hôpital gynéco-obstétrique et pédiatrique de Yaoundé (Cameroun).

OBJECTIVE: To identify the risk factors for emergency cesarean deliveries and assess the effects of the emergency situation on maternal and fetal prognosis. METHODS: This retrospective cohort study compared emergency and elective cesarean deliveries performed at the Yaoundé Women's and Children's Hospital in Cameroon, analyzing socioeconomic variables, the indications for surgery, and complications for mother and child. RESULTS: Risk factors predisposing to emergency cesareans were: age <20 years, not having a salaried job, unmarried status, no university-level education, referral from other health facilities, primiparity, prenatal care in a health center or in a district hospital, prenatal care by a nurse, and preadmission rupture of membranes. Emergency cesareans increased the mothers risk of general anesthesia, unavailability of standard preoperative work-up during surgery, infection, and a longer hospital stay. Babies born by emergency cesarean delivery had a higher risk of admission to the neonatology unit, neonatal asphyxia, neonatal infection, preterm birth, and perinatal death. CONCLUSION: In our setting, lack of reproductive experience (primiparity), low socioeconomic level, poor prenatal care, and preadmission rupture of membranes were risk factors for emergency cesarean deliveries. The emergency situation exposes mother and child to a significant risk of morbidity and mortality.

[Diagnosis and treatment of breast cancer in Cameroon: a series of 65 cases]. / Diagnostic et traitement du cancer de sein au Cameroun: a propos de 65 cas.

AIM: The objective was to describe the clinical and therapeutic aspects of breast cancer at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, which is a referral centre for gynecological malignancies. METHODS: It was a retrospective descriptive study over a period of four years, from June 1st 2003 to May 31st 2007. RESULTS: Sixty five patients were identified during the study period. The mean age and parity were respectively 42.9 ±13.6 years and 3.9 ± 2.1. The mean age of onset of the first menses was 14.0 ± 1.5 years. Most patients were under 50 (72.3%) and had given birth at least once (89.2%). Non menopausal period (75.4%) and breastfeeding (76.9%) were frequently found. The patients consulted 9.2 ± 3.4 months after the onset of symptoms, with 78.5% of cases arriving at a local advanced clinical stage. Ductal carcinoma accounted for 75.4% of histological types, SBR grades 1 and 2 being the most frequent (89.2%). Chemotherapy (69.2% of the cases) and surgery (67.7% of the cases) often radical (three out of four) were the main treatment modalities used. CONCLUSION: In Yaounde, breast cancer is often a ductal carcinoma of high histological grade, attacking the quarantine non menopausal woman, who gave birth and breastfed at least once, diagnosed with a local clinical advanced disease. Chemotherapy and surgery are the main therapeutic options implemented.

BUT: Il s'agissait de décrire les aspects cliniques et thérapeutiques du cancer du sein à l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé qui est un centre de référence pour la prise en charge des cancers gynécologiques. MATÉRIEL ET MÉTHODES: C'était une étude descriptive rétrospective sur une période de 4 ans allant du 1er Juin 2003 au 31 Mai 2007. RÉSULTATS: Soixante-cinq malades ont été colligées pendant la période de l'étude. L'âge et la parité moyennes étaient respectivement de 42,9 ±13,6 ans et 3,9 ± 2,1. L'âge moyen de survenue des ménarches était de 14,0 ± 1,5 ans. La plupart des patientes avait moins de 50 ans (72,3%) et avait accouché au moins une fois (89,2%). La période non ménopausique (75,4%) et l'allaitement au sein (76,9%) étaient fréquemment retrouvés. Le délai moyen de consultation était de 9,2 ± 3,4 mois, avec 78,5% des cas arrivant à un stade clinique local avancé. Le carcinome canalaire représentait 75,4% des types histologiques, les grades histologiques SBR 2 et 3 étant les plus fréquents (89,2%). La chimiothérapie (69,2% des cas) et la chirurgie (67,7% des cas) souvent radicale ( trois fois sur quatre) étaient les principales modalités thérapeutiques utilisées. CONCLUSION: A Yaoundé, le cancer du sein est souvent un carcinome canalaire de haut grade histologique, intéressant la quarantenaire non ménopausée, ayant accouché et allaité au sein, et consultant à un stade local avancé. Il est souvent pris en charge par chimiothérapie et par chirurgie.

Conservative treatment of ectopic pregnancy in a sub-Saharan African setting.

In the sub-Saharan African setting, laparotomy for salpingectomy is the common method of treatment for ectopic pregnancy (EP). The objective of this retrospective study was to find out how common EP is treated conservatively in the Yaounde Gynaeco-Obstetric and Paediatric Hospital, Cameroon. Of the 281 patient files analysed, 126 patients (44.8%) were treated conservatively and successfully for EP. Of these, 86 (68.2%) had received conservative surgical treatment while 40 (31.8%) had non-surgical treatment. Salpingostomy was the conservative surgery for 79.1% of the cases. According to the publications available for the sub-Saharan setting, the rate of conservative management of EP at the Yaounde Gynaeco-Obstetric and Paediatric Hospital, Cameroon is high. We recommend that this rate should be improved so that, eventually, the conservative treatment methods of EP become routine.