Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triag...Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> The SARS-CoV-2 and associated corona virus disease COVID-19</span><span style="font-family:Verdana;"> h...<strong>Background:</strong><span style="font-family:Verdana;"> The SARS-CoV-2 and associated corona virus disease COVID-19</span><span style="font-family:Verdana;"> ha</span><span style="font-family:Verdana;">ve</span><span style="font-family:Verdana;"> been declared a pandemic having a poor prognosis among individuals with debilitating conditions and those who are immune</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">compromised. Current evidence is however limited on maternal and fetal transmission and pregnancy outcomes. We aimed to describe the pattern of SARS-CoV-2 infection and outcomes in a group of pregnant women followed</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">up at a tertiary care unit in Cameroon. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This was an observational study conducted over a period of 3 months (April 1</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">to June 30, 2020) at the Yaounde Central Hospital. All pregnant women who were tested positive for SARS-CoV-2 and who provided a signed written informed consent were included in the study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Out of 83 pregnant women who presented with symptoms suspicious of COVID-19, 25 were tested positive. The median age of these women was 31 (27 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 35)</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">years. A total of 76% consulted within 6 days of onset of symptoms and 68% had a gestational age greater than 28 weeks. The most comm</span><span style="font-family:Verdana;">on </span><span style="font-family:Verdana;">presenting complaint was fever (88%). All 25 pregnant women who </span></span><span style="font-family:Verdana;">were </span><span style="font-family:Verdana;">tested posit</span><span style="font-family:Verdana;">i</span><span style="font-family:Verdana;">ve for COVID-19 were followed up with 9/25 deliveries registered. There were two intra-uterine f</span><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">tal death</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> and seven live births. All the live birth babies </span><span style="font-family:Verdana;">were </span><span style="font-family:""><span style="font-family:Verdana;">tested negative on Real Time-Polymerase Chain Reaction (RT-PCR) testing which was performed after birth. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Deliverance of live and SARS-CoV-2 negative babies from COVID-19 pregnant women is possible.</span></span>展开更多
Background: Pre-eclampsia (PE) frequently leads to adverse maternal and foetal outcomes in our setting. The pathophysiology is strongly linked to placental development. We aimed to study placental lesions associated w...Background: Pre-eclampsia (PE) frequently leads to adverse maternal and foetal outcomes in our setting. The pathophysiology is strongly linked to placental development. We aimed to study placental lesions associated with PE in a population of Cameroonian women. Methods: We conducted a cross-sectional, analytical study in three university teaching hospitals in Yaounde namely, the Yaounde Central Hospital, the pathology laboratory of the Yaounde University Hospital Centre, and the Yaounde Gynaeco-Obstetric and Paediatric Hospital. The study spanned 8 months from January 1<sup>st</sup> to September 1<sup>st</sup>, 2021. Placental analysis was carried out as per standard protocol. The study included 101 parturients with pre-eclampsia. These were divided into two groups, with groups 1 and 2 being made of patients with mild pre-eclampsia (n = 40), and severe pre-eclampsia (n = 61), respectively. Results: The mean ages of the two groups were 29.93 ± 7.36 versus 28.28 ± 7.18 (p = 0.267) for patients with mild and severe pre-eclampsia respectively. Low socioeconomic status was the most frequently identified risk factor in both groups (59%). Patients’ history revealed that the women with severe pre-eclampsia tended to have poor pregnancy follow-up compared to those with mild pre-eclampsia (p < 0.05). Also, the placentas of patients with severe pre-eclampsia weighed significantly less than those of patients with mild pre-eclampsia (454.4 ± 122 vs. 511.7 ± 125;p < 0.05). Pre-eclampsia-related lesions were significantly greater in patients with severe disease (p Conclusion: PE-related placental lesions in our context are multiple and diverse especially in severe disease, and these arise as a result of defective maternal vascular perfusion.展开更多
<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Prolonged Second Stage of Labor (SSL) is known to increase maternal and fo...<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software.</span><b><span style="font-family:Verdana;"> Results:</span></b><span style="font-family:Verdana;"> Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%;28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%;18/120) and perinatal asphyxia (7.5%;9/120). Maternal complications were significantly increased in women with an SSL lasting 1</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (44.9% versus 22.7%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and >2 hours (42.9% versus 22.7%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and 19.0% for SSLs ></span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.007).</span><b><span style="font-family:Verdana;"> Conclusion:</span></b><span style="font-family:Verdana;"> Maternal and foetal complications increase when the SSL exceeds 1 hour in primiparas. Identifying factors that predispose to a prolonged SSL and indicating appropriate interventions could help prevent morbidity.</span></span>展开更多
Context: In Cameroon, breast cancer (BC) is usually diagnosed late in the disease course. About a third of women affected are aged less than 40 years. Chemotherapy (CT) could alter ovarian function and thereby comprom...Context: In Cameroon, breast cancer (BC) is usually diagnosed late in the disease course. About a third of women affected are aged less than 40 years. Chemotherapy (CT) could alter ovarian function and thereby compromise future fertility in these women. We therefore described the fertility of women following CT for BC in women treated at the Yaounde General Hospital (YGH). Methods: It was a retrospective, descriptive, cross-sectional study conducted over 8 months, from January to August 2017. We used the files of patients managed for BC from January 2011 to December 2015 in the medical oncology unit of the YGH. Results: We included 265 patients for the study following at least one year of CT. The mean age at the onset of CT was 35.9 ± 6.9 years. Most of the patients had fewer than 2 deliveries (68.3%). Intraductal carcinoma was the most frequent histological lesion (90.6%) and most often diagnosed in advanced stages (73.5%). As per CT, the FAC protocol was the most used (44.5%). The menstrual cycles of the patients were more regular prior to the onset of chemotherapy (89.4% vs. 58.9%), while the mean period of resumption of menstrual activity following cessation of chemotherapy was 6.3 ± 2.0 months. Chemotherapy-related amenorrhoea was observed in 29.1% of patients after 12 months of treatment. More than half of these women (51.3%) complained of a drop in libido and 6.4% achieved pregnancy within 13 months following cessation of chemotherapy. Conclusion: Following chemotherapy for BC, menstrual cycle disorders are more frequent and this can affect the patients’ reproductive potential. Fertility consultations should be integrated into the management plan of such patients.展开更多
文摘Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> The SARS-CoV-2 and associated corona virus disease COVID-19</span><span style="font-family:Verdana;"> ha</span><span style="font-family:Verdana;">ve</span><span style="font-family:Verdana;"> been declared a pandemic having a poor prognosis among individuals with debilitating conditions and those who are immune</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">compromised. Current evidence is however limited on maternal and fetal transmission and pregnancy outcomes. We aimed to describe the pattern of SARS-CoV-2 infection and outcomes in a group of pregnant women followed</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">up at a tertiary care unit in Cameroon. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This was an observational study conducted over a period of 3 months (April 1</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">to June 30, 2020) at the Yaounde Central Hospital. All pregnant women who were tested positive for SARS-CoV-2 and who provided a signed written informed consent were included in the study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Out of 83 pregnant women who presented with symptoms suspicious of COVID-19, 25 were tested positive. The median age of these women was 31 (27 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 35)</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">years. A total of 76% consulted within 6 days of onset of symptoms and 68% had a gestational age greater than 28 weeks. The most comm</span><span style="font-family:Verdana;">on </span><span style="font-family:Verdana;">presenting complaint was fever (88%). All 25 pregnant women who </span></span><span style="font-family:Verdana;">were </span><span style="font-family:Verdana;">tested posit</span><span style="font-family:Verdana;">i</span><span style="font-family:Verdana;">ve for COVID-19 were followed up with 9/25 deliveries registered. There were two intra-uterine f</span><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">tal death</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> and seven live births. All the live birth babies </span><span style="font-family:Verdana;">were </span><span style="font-family:""><span style="font-family:Verdana;">tested negative on Real Time-Polymerase Chain Reaction (RT-PCR) testing which was performed after birth. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Deliverance of live and SARS-CoV-2 negative babies from COVID-19 pregnant women is possible.</span></span>
文摘Background: Pre-eclampsia (PE) frequently leads to adverse maternal and foetal outcomes in our setting. The pathophysiology is strongly linked to placental development. We aimed to study placental lesions associated with PE in a population of Cameroonian women. Methods: We conducted a cross-sectional, analytical study in three university teaching hospitals in Yaounde namely, the Yaounde Central Hospital, the pathology laboratory of the Yaounde University Hospital Centre, and the Yaounde Gynaeco-Obstetric and Paediatric Hospital. The study spanned 8 months from January 1<sup>st</sup> to September 1<sup>st</sup>, 2021. Placental analysis was carried out as per standard protocol. The study included 101 parturients with pre-eclampsia. These were divided into two groups, with groups 1 and 2 being made of patients with mild pre-eclampsia (n = 40), and severe pre-eclampsia (n = 61), respectively. Results: The mean ages of the two groups were 29.93 ± 7.36 versus 28.28 ± 7.18 (p = 0.267) for patients with mild and severe pre-eclampsia respectively. Low socioeconomic status was the most frequently identified risk factor in both groups (59%). Patients’ history revealed that the women with severe pre-eclampsia tended to have poor pregnancy follow-up compared to those with mild pre-eclampsia (p < 0.05). Also, the placentas of patients with severe pre-eclampsia weighed significantly less than those of patients with mild pre-eclampsia (454.4 ± 122 vs. 511.7 ± 125;p < 0.05). Pre-eclampsia-related lesions were significantly greater in patients with severe disease (p Conclusion: PE-related placental lesions in our context are multiple and diverse especially in severe disease, and these arise as a result of defective maternal vascular perfusion.
文摘<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software.</span><b><span style="font-family:Verdana;"> Results:</span></b><span style="font-family:Verdana;"> Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%;28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%;18/120) and perinatal asphyxia (7.5%;9/120). Maternal complications were significantly increased in women with an SSL lasting 1</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (44.9% versus 22.7%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and >2 hours (42.9% versus 22.7%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:Verdana;"> < </span><span style="font-family:Verdana;">0.001) and 19.0% for SSLs ></span><span style="font-family:""> </span><span style="font-family:Verdana;">2 hours (versus 6.3%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.007).</span><b><span style="font-family:Verdana;"> Conclusion:</span></b><span style="font-family:Verdana;"> Maternal and foetal complications increase when the SSL exceeds 1 hour in primiparas. Identifying factors that predispose to a prolonged SSL and indicating appropriate interventions could help prevent morbidity.</span></span>
文摘Context: In Cameroon, breast cancer (BC) is usually diagnosed late in the disease course. About a third of women affected are aged less than 40 years. Chemotherapy (CT) could alter ovarian function and thereby compromise future fertility in these women. We therefore described the fertility of women following CT for BC in women treated at the Yaounde General Hospital (YGH). Methods: It was a retrospective, descriptive, cross-sectional study conducted over 8 months, from January to August 2017. We used the files of patients managed for BC from January 2011 to December 2015 in the medical oncology unit of the YGH. Results: We included 265 patients for the study following at least one year of CT. The mean age at the onset of CT was 35.9 ± 6.9 years. Most of the patients had fewer than 2 deliveries (68.3%). Intraductal carcinoma was the most frequent histological lesion (90.6%) and most often diagnosed in advanced stages (73.5%). As per CT, the FAC protocol was the most used (44.5%). The menstrual cycles of the patients were more regular prior to the onset of chemotherapy (89.4% vs. 58.9%), while the mean period of resumption of menstrual activity following cessation of chemotherapy was 6.3 ± 2.0 months. Chemotherapy-related amenorrhoea was observed in 29.1% of patients after 12 months of treatment. More than half of these women (51.3%) complained of a drop in libido and 6.4% achieved pregnancy within 13 months following cessation of chemotherapy. Conclusion: Following chemotherapy for BC, menstrual cycle disorders are more frequent and this can affect the patients’ reproductive potential. Fertility consultations should be integrated into the management plan of such patients.
