Risk factors of intrauterine fetal death: a case control study at the maternity of Yaoundé Central Hospital

Background: Intrauterine fetal death (IUFD) is the death before the beginning of the work of the fetus from the 28th week of pregnancy or a fetus of weight greater than or equal to 1000g. It occurs in 98% in poor countries, particularly in sub-Saharan Africa. The aim of this study was to identify the risk factors for IUFD in low-income countries.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA-pulsatility index (PI) and UA-resistive index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI<2SD was taken as abnormal.Results: Independent risk factors for IUFD are age over 30 years (ORa = 2.1, P = 0.052), (ORa = 2.4497, p = 0.01), household occupation (ORa = 2.0097, p = 0.0282), hypertension disorders (ORa = 2.11, p = 0.0176), antepartal haemorrhage (ORa = 3.9635, p = 0.000), multiparity (ORa = 13.3089, p = 0.0056).Conclusions: The main risk factors for IUFD identified in our study are maternal age greater than 30 years, hypertension, antepartal haemorrhage, multiparity, and the household profession. Any pregnant woman who has one of these factors should be follow-up closely during pregnancy with a weekly assessment of fetal well-being by the 28th week

Fetal outcome of HIV positive pregnant women taking highly active antiretroviral therapy at Yaoundé Central Hospital: a cross sectional analytic study

Background: HIV infection in pregnant women is delicate both for the mother and her child. With the adoption of option B+ treatment plan by Cameroon’s ministry of public health, there has been a marked decrease in the vertical transmission of HIV from mothers to their babies. There is a dearth of evidence in sub-Saharan Africa, especially in Cameroon, on the effects of highly active antiretroviral therapy (HAART) on pregnancy and foetal outcomes with respect to the time from onset of treatment. We therefore carried out this study to determine the foetal outcome of women on HAART. We hypothesized that the foetal outcome is poorer for pregnant women starting HAART during pregnancy compared to those starting HAART prior to conception.Methods: We carried out an analytic cross-sectional study which spanned from the 1st February to 30th April 2017 at the Yaoundé Central Maternity. We included consenting hospitalised HIV infected women who just terminated a pregnancy (abortion or delivery), and who started HAART at least four weeks before termination of pregnancy. Data was analysed using EPI info 7.2.1.0. SPSS version 20.0. Odds ratio (OR) was used to assess the degree of association that could exist between qualitative variables. The threshold of statistical significance was set at a p-value of 0.05.Results: A total of 121 participants were recruited in the present study. The mean age of the participants was 31.3±5.3 years for those who started HAART before pregnancy and 29.4±5.5 years for those who started during pregnancy (p=0.07). The viral loads means for those who started taking HAART before pregnancy 34.6±21.5 cells/mm3 and those who started during pregnancy 60±14 cells/mm3 (p = 0.01). Overall there were not any significant adverse fetal outcomes caused by taking HAART before or during pregnancy (p >0.05).Conclusions: Despite the fact that the viral load was more elevated in women starting HAART prior pregnancy compared to those started during pregnancy, there was no significant adverse foetal outcome related to time of initiation of HAART treatment by pregnant HIV positive in Yaoundé central Maternity. We suggest that the implementing of the test and treat strategy will have a positive impact on the vertical transmission of HIV

Knowledge, attitudes and practices of cervical cancer screening by health care providers in the Emana health area: Yaounde-Cameroon

Background: Gynaecological cancers and more particularly those of the cervix cause many victims in our country despite the many prevention tools that exist. The objective of this study was to assess the knowledge, attitudes and practices of providers on cervical cancer in the Emana health area.Methods: To achieve this objective, we conducted a cross-sectional study form the period from April 2nd to June 10th, 2019 in the health facilities of the Emana health area.Results: A total of 64 healthcare providers participated in the study, 03 gynecologists and obstetricians, 10 General practitioners, 30 state-certified nurses, 09 midwives, 12 nursing assistants. The majority of these providers had poor knowledge of the causes of the disease (25%), risk factors (34.4%), and means of prevention (39.1%), especially among state nurses (SRN), midwives, nursing assistants. (87.5%) had good knowledge of the clinical signs of the disease and were almost unanimous on the curability of this disease when discovered early (78.1%). The severity of the cancer was perceived by all; however, the practice of screening was low (10.9%). As for their personal screening practices, 73.1% (38/52) of female staff had never been screened.Conclusions: Even though the participants perceive the grave nature of the cervical cancer, the subsequent attitude and screening practices remain poor. The possible barrier to this is the insufficient continuous training and recycling of the health personnel. Emphasis should be laid on the methods of prevention of cervical cancer in the curricula of nurses and midwives in Cameroon