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Background: Intrauterine ectopic pregnancies (IUEP) are uncommon. However, invasive management technics are usually required and this could compromise fertility, or obstetric and life prognosis in subsequent pregnancies. Objective: we aimed to assess the occurrence of pregnancy after an IUEP and the outcome of these pregnancies in 2 hospitals in Yaoundé, Cameroon. Methods: this was a descriptive cross-sectional study carried out on a 5-years period (2018-2022) with an exhaustive sampling. The study was done at two reference hospitals in Yaoundé and lasted 09 months (December 2023 to August 2024). We reviewed theatre registers for cases and searched for their files from which case details were extracted. We completed data through phone calls and used descriptive statistics as appropriate. Results: we found a total of 78 intrauterine (cornual or interstitial), excluded 37 cases and 41 cases were considered. Out of the 41 patients considered in the study, 17 conceived, 10 had reached at least 30 weeks of gestation with 3 still pregnant and 7 had a term delivery; of which 3 were vaginal and 4 by caesarean section. We recorded no uterine rupture. Conclusion: The fertility after IUEP was good and the outcome of subsequent pregnancies was favourable, with a slight preference for caesarean section as route of delivery.

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Background: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality, mainly due to complication, especially in resource-limited settings. This study aimed to identify maternal factors associated with PE complications, to help identify ways to orient limited resources. Methods: We conducted a case-control study at three tertiary hospitals in Yaoundé: the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, University Teaching Hospital, and Central Hospital. Records of women admitted for preeclampsia between January 2022 and December 2023 were reviewed. Cases were women with maternal complications of preeclampsia, while controls were those with preeclampsia and no complications, matched by maternal age. Data were analysed using R version 4.3.3. Pearson’s chi-squared test and Student’s t-test were used for comparisons, and adjusted odds ratios (aORs) determined using multiple logistic regression. Results: We recruited 291 participants (97 cases and 194 controls). The most frequent complications were eclampsia (59.2%) and HELLP syndrome (18.5%). Risk factors were alcohol consumption during pregnancy (aOR = 2.53; 95% CI: 1.19–5.40; p=0.016) and having a new partner (aOR = 3.63; 95% CI: 1.14–11.57; p=0.029). Age >20 years (aOR = 0.87; 95% CI: 0.80–0.94; p<0.001), and having ≥ 5 ANCs (aOR = 0.71; 95% CI: 0.58–0.88; p=0.001), were protective. Conclusion: Eclampsia was the most common complication of PE at these hospitals. Factors associated with complications were alcohol consumption, a new partner, and suboptimal ANC. We emphasize the importance of optimum antenatal care, and avoidance of alcohol, to promote prevention and early case detection and management.

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Introduction: Post–spinal anesthesia bacterial meningitis is an exceptional complication, most often caused by Gram-positive cocci originating from the oropharyngeal flora. Infections due to Escherichia coli are extremely rare and are generally reported as isolated cases. Case Report: We report the case of a 37-year-old woman with no previous medical history who developed altered consciousness twelve hours after a cesarean section performed under spinal anesthesia. Clinical examination revealed obnubilation, neck stiffness, and cloudy cerebrospinal fluid. Cerebrospinal fluid culture isolated Escherichia coli sensitive to ceftriaxone. A breach in aseptic technique was identified, involving the use of the paper inner packaging of a pair of surgical gloves as an operative drape. Early antibiotic therapy with ceftriaxone combined with corticosteroid therapy resulted in a favorable outcome without sequelae after 21 days of treatment. Conclusion: This case illustrates the rare but serious occurrence of Escherichia coli meningitis following spinal anesthesia and highlights the importance of strict aseptic technique, rapid diagnosis, and early antibiotic treatment. Exclusive use of certified sterile surgical drapes remains an essential preventive measure.

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Introduction: Despite improvements in health, maternal mortality remains a global public health problem. The haemorrhages of the third trimester are still responsible for a heavy mortality. Objectives: Contribute to the study of immediate postpartum hemorrhages (PPH) at the maternity department of Nabil Choucair Health Center (NBHC). Methodology: It was a retrospective descriptive and analytical study on cases of PPH treated between of January 1st, 2011 and December 31th, 2015 at the maternity department of NBHC. We included any patient who was being cared for in the maternity waedfor a PPH. We studied the sociodemographic characteristics of the patients, identified etiological factors and evaluated treatment and prognosis. Results: The frequency of PPH was 1.1%. The mean age of the patients was 27.5 years. Primiparas (34.3%) and pauciparas (33.3%) were the most affected. The main etiologies of PPH were traumatic lesions (39.6%), uterine atony (31%) and retained placenta (25.2%). Medical management was based on resuscitation using filling fluids, transfusion (22.4%) and administration of oxytocin (51.4%) and prostaglandin analogs associated with oxytocin (48.6%). Obstetrical care consisted of uterine revision and uterine massage (59.8%), uterine revision alone (20.4%) and uterine revision, uterine massage and sandbag placement (19.1%). The mechanical means were mainly represented by intra-vaginal tamponade (69.2%) and intrauterine tamponade (24.4%), including 2 with the balloon. The surgical treatment included 18 hemostasis hysterectomies (13.1%) and 118 (85.5%) restorative sutures. The main maternal complication of PPH was anemia (71%). The lethality related to PPH was 6.8% with 14 deaths including 7 from blood clotting disorders. Conclusion: The diagnosis and precise estimation of postpartum hemorrhage are the basic elements of the course to be taken.

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DEAR EDITOR Congenital uterine anomalies arise from abnormal embryological development of the paramesonephric ducts (or Mullerian ducts) [1]. Various anomalies result from arrested development of the uterovaginal primordium during embryonic period, by incomplete or failed development of parts of one or both paramesonephric duct, incomplete fusion of the paramesonephric ducts or incomplete canalization of the vaginal plate [2]. Prevalence of all types of female congenital reproductive tract malformations is estimated at 4%–7% and they are mostly benign [3]. Uterine didelphys is a rare type of anomaly with estimated prevalence of 0.3%, caused by complete failure of fusion of the inferior parts of the paramesonephric ducts resulting in separate uterine cavities with two cervices and a double or single vagina. Sometimes a longitudinal or transverse vaginal septum varying from thin and easily displaceable to thick and inelastic may also

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Introduction: The current strategy to combat maternal and infant mortality is essentially based on three pillars which are family planning, childbirth assisted by qualified personnel (midwife, nurse, doctor) and emergency obstetric and newborn Care (EmONC). Objective: Evaluate the care of parturients in the gynecology and obstetrics department of the Institute of Social Hygiene in Dakar. Patients and Methods: We conducted a retrospective and descriptive study conducted over a period of six months from January 1st to June 30th, 2019 on the management of births in the Gynecology and Obstetrics department of the Hospital Institute of Social Hygiene in Dakar. We studied the epidemiological, clinical parameters of parturients and the prognosis of childbirth. Results: We collected 689 birth records, representing 8.2% of the overall activities of the service and 69% of emergency activities. The epidemiological profile of our parturients was that of a young primipare (41%) with an average age of 27.4 years, married (96%) with a history of cesarean section (14.6%), who had completed at least 4 prenatal consultations (58.1%) and carried a pregnancy to term (72%). The evacuees represented (43.7%) parturients and came mainly from outside the southern health district (61.8%). More than half of the parturients had given birth vaginally (55.3%). The cesarean section and instrumental extractions accounted for 44.6% and 0.1%, respectively. We recorded 706 births, 98% of which were alive. The stillbirth (20) was distributed as follows: 9 fresh stillbirths and 5 macerated stillbirths. Conclusion: The current strategy to combat maternal and infant mortality must be strengthened on the ground by properly filling out birth records, promoting and using partograms and recording fetal heart rate.

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The word paraphimosis is derived from two Greek words: "para" (meaning "beyond" or "resembling") and "phimosis" (meaning "to muzzle" or "to restrict"). It is a true urological emergency. [1, 2]. We report a case of iatrogenic paraphimosis after urinary catheterization and review the literature. This is a 2-year-old male patient who presented to the urology department with plaintive cries, painful penile swelling, fever, and vomiting after transurethral catheterization for acute urinary retention. Physical examination revealed a retracted foreskin behind the corona of the glans with swollen and edematous preputial mucosa. He also had a fever of 38.2°C. Paraphimosis is a rare urological emergency. In 15 years of urological practice, we have recorded only one case. Burstein and Paquin, from Canada, reported 46 patients between October 2013 and September 2016 [18]. If left untreated, it can lead to catastrophic penile lesions. The treatment was surgery. It is important to return the foreskin to its original position after urethral catheterization or cystoscopy.