Update on the use of misoprostol in current obstetric practice

Misoprostol is one of the most important drugs in obstetric practice today. However, because of its uterotonic effects and consequent adverse effects on the pregnant uterus and foetus, the use of this drug requires extreme caution and very close monitoring particularly in developing countries. The aim of this update is to review the pharmacokinetics and the physiology of misoprostol and to familiarise fellow practitioners with information and evidence concerning this medication as it is currently available for use in obstetric practice. Clinics in Mother and Child Health Vol. 3(1) 2006: 483-48

Triple Gestations in Two University Teaching Hospitals in Yaounde, Cameroon

The frequency of triplet pregnancies is increasing due to medically assisted reproduction. This retrospective study, carried out in 2 university hospitals in Yaounde (Cameroon) over a 6-year period, was done to evaluate the complications that occurred during triple pregnancies as well as the mode of delivery of triplets. A total of 43 cases were analyzed. The most common complications that occurred during pregnancy were preterm delivery and pre-eclampsia. Twenty seven women (62.8%) delivered vaginally and 16 (37.2%) were delivered by caesarean section with the most common indications being mal presentation and cord prolapse of the 1st triplet. In patients who have proper antepartum monitoring, it is possible to pre-select cases for trial of vaginal delivery because vaginal delivery is possible and carries no significant risk for the foetuses.Keywords triplet gestations; pre-eclampsia; premature delivery; vaginal delivery; caesarean sectio

Rupture of a previously scarred uterus during second trimester misoprostol-induced labour for a missed abortion: A case report

Misoprostol is useful in ripening the cervix prior to mid-trimester termination of pregnancy. It is particularly indicated in cases of missed abortions whether the uterus is scarred or not. The procedure is safe in the majority of cases. We present a case of uterine rupture during induction of labour with vaginal misoprostol for a missed abortion at 23 weeks gestation in a woman with one previous lower segment caesarean scar. We decided to present this case in order to alert practitioners that although the practice is safe in the majority of cases, there are risks of uterine rupture. Clinics in Mother and Child Health Vol. 3(1) 2006: 501-50

Chlamydiatrachomatis and placental inflammation in early preterm delivery

Chlamydiatrachomatis may infect the placenta and subsequently lead to preterm delivery. Our aim was to evaluate the relationship between the presence of Chlamydiatrachomatis and signs of placental inflammation in women who delivered at 32 weeks gestation or less. Setting: placental histology and clinical data were prospectively obtained from 304 women and newborns at the Erasmus MC-Sophia, Rotterdam, the Netherlands. C.trachomatis testing of placentas was done retrospectively using PCR. C.trachomatis was detected in 76 (25%) placentas. Histological evidence of placental inflammation was present in 123 (40%) placentas: in 41/76 (54%) placentas with C.trachomatis versus 82/228 (36%) placentas without C.trachomatis infection (OR 2.1, 95% CI 1.2–3.5). C.trachomatis infection correlated with the progression (P = 0.009) and intensity (P = 0.007) of materno-fetal placental inflammation. C.trachomatis DNA was frequently detected in the placenta of women with early preterm delivery, and was associated with histopathological signs of placental inflammation

Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study

Chlamydia trachomatis infection is the most prevalent bacterial sexually transmitted infection and may influence pregnancy outcome. This study was conducted to assess the effect of chlamydial infection during pregnancy on premature delivery and birthweight. Pregnant women attending a participating midwifery practice or antenatal clinic between February 2003 and January 2005 were eligible for the study. From 4,055 women self-administered questionnaires and urine samples, tested by PCR, were analysed for C. trachomatis infection. Pregnancy outcomes were obtained from midwives and hospital registries. Gestational ages and birthweights were analysed for 3,913 newborns. The C. trachomatis prevalence was 3.9%, but varied by age and socio-economic background. Chlamydial infection was, after adjustment for potential confounders, associated with preterm delivery before 32 weeks (OR 4.35 [95% CI 1.3, 15.2]) and 35 weeks gestation (OR 2.66 [95% CI 1.1, 6.5]), but not with low birthweight. Of all deliveries before 32 weeks and 35 weeks gestation 14.9% [95% CI 4.5, 39.5] and 7.4% [95% CI 2.5, 20.1] was attributable to C. trachomatis infection. Chlamydia trachomatis infection contributes significantly to early premature delivery and should be considered a public health problem, especially in young women and others at increased risk of C. trachomatis infection

A Case Report Of Silent Uterine Rupture In A Parturient On Epidural Anaesthesia

Uterine rupture occurs most of the time during labour. It is a condition in which maternal and foetal morbidities and mortalities are increased. A variety of signs and symptoms can help in early diagnosis. Unfortunately, some of these signs and symptoms can be sometimes masked by epidural anesthesia, or may be similar to the side effects of epidural anesthesia. We hereby report the case of a parturient under epidural anesthesia whose diagnosis of uterine rupture was delayed, and we advise on the precautions that must be taken in parturients under epidural anesthesia.La rupture utérine survient habituellement pendant le travail. Elle est associée à une morbidité et une mortalité maternelles et surtout foetales très élevées. Un certain nombre de signes fonctionnels et physiques peuvent aider au diagnostic précoce. Malheureusement, certains de ces signes peuvent être masqués par une anesthésie péridurale, ou peuvent être similaires aux effets indésirables de celle-ci. Nous présentons ici le cas d\'une parturiente sous anesthésie péridurale chez qui le diagnostic de rupture utérine a été retardé, et nous proposons des précautions à prendre chez les parturientes sous anesthésie péridurale Keywords: Epidural anesthesia- Uterine rupture- Minor symptoms- Delayed diagnosis.Clinics in Mother and Child Health Vol. 5 (2) 2008: pp. 941-94

Rupture uterine au centre hospitalier et universitaire de Yaounde au Cours des 10 derniere annees (1997-2006)

No abstractClinics in Mother and Child Health Vol. 4 (1) 2007: pp. 651-65

Standard gestational birth weight ranges and Curve in Yaounde, Cameroon

The aim of this study was to establish standard ranges and curve of mean gestational birth weights validated by ultrasonography for the Cameroonian population in Yaoundé. This cross sectional study was carried out in the Obstetrics & Gynaecology units of 4 major hospitals in the metropolis between March 5 and December 20, 2004, using pre-coded questionnaires. A total of 546 birth weights of neonates delivered to Cameroonian mothers whose duration of pregnancy were validated to be at least 28 weeks were recruited. The data was analysed using the statistical package SPSS 10.0. There was a statistically significant correlation between mean birth weight and mean gestational age (r=0.792,