Cord prolapse, associated factors and fetal outcome: a report of 47 cases from the Yaounde Central Hospital, Cameroon.

Cord prolapse is a condition in which the umbilical cord comes ahead of the presenting part. Fetal demise occurs as a consequence of the compression of the cord by the presenting part. We conducted this study to determine profile of pregnancy and its outcome at the Central Hospital Yaounde, Cameroon. This was an observational, descriptive and retrospective study of deliveries complicated by cord prolapse between January 2003 and December 2006 at the Central Maternity of the Central Hospital Yaounde. Data was retrieved from patient’s files, operation room registers and admission registers. During this period, there were a total of 6924 deliveries amongst which 47 were complicated by umbilical cord prolapse (2.8 per 1000 deliveries). Among the women with cord prolapse, 62.2% were delivered by emergency caesarean section. Fetal demise was reported in 32 % of the women upon admission. An abnormal pelvis was seen in 25.5% of the women. Artificial rupture of membranes was carried out in 40.4%. This study shows that cord prolapse is associated with severe fetal consequences in our unit. A good knowledge of the risk factors, prompt diagnosis and rapid intervention by medical staff are required.KEY WORDS: Cord prolapsed - Perinatal morbidity and mortality - Caesarean section - Vaginal delivery

A survey of the knowledge, attitude and practice of the labour partogramme among health personnel in seven peripheral hospitals in Yaounde, Cameroon.

Late referrals of complicated labour cases and prolonged labour contribute a major part in maternal morbidity and mortality. The labour partogramme has been shown to be an effective instrument in the follow-up of labour cases. The referal maternities of Yaounde still receive delayed and poorly managed cases of labour from the peripheral hospitals. The rationale of this study was to assess the knowledge, attitude and practice of the labour partogramme among the health personnel in the main centers where referrals come from. We interviewed the personnel of those hospitals who accepted to enroll in the study. Students and those who were not willing to participate in the study were excluded, and the study lasted for 3 months from January to March 2006. Our results showed that the personnel had a good knowledge of the labour partogramme, especially (100%) amongst the doctors. They also had a positive attitude towards the labour partogramme. However, the partogramme was not routinely used, with only 50% of the respondents who accepted using it regularly. Most of them blamed the low rate of use to the unavailability of the partogramme. Despite the very good knowledge of the labour partogramme and the positive attitude towards its use, the rate of use still remains very low. We do recommend that the training of the personnel should be more practical and the labour partogramme made available to both private and public hospitals. An audit system should also be put in place to ensure the effective use of the partogramme.KEY WORDS: Partogramme – Labour – Knowledge – Attitude - Practice

Interactions between human immunodeficiency virus and herpes viruses within the oral mucosa

ABSTRACTThere is evidence from clinical case reports and epidemiological studies that human immunodeficiency virus (HIV) can be transmitted through oral sex. Herpes viruses that appear in the oral mucosa might influence the oral replication of HIV. A review of data suggesting that interactions occur between HIV and herpes viruses indicates that such interactions might operate in the oral mucosa. Defining the mechanisms by which herpes viruses interact with HIV in the oral mucosa should permit intervention measures to be targeted more precisely