Risk factors of delivery by caesarean section in cameroon (2003-2004): a regional hospital report

We conducted this retrospective case-control study to identify possible risk factors of delivery through caesarean section in the Far North Region of Cameroon. Data was collected retrospectively from delivery room registers at the Provincial Hospital, Maroua, Cameroon from 01/01/2003 to 31/12/2004. The overall 125 eligible caesarean deliveries were compared with 244 women who delivered vaginally during the study period. The odds ratio as well as the 95% confidence interval was used to measure the relationship between maternal characteristic and risk of delivery by caesarean section. We found that the marital status is similar in the two study populations. Risk factors associated with cesarean section were: maternal age less than 17 years (OR 3.55, 95%CI: 1.46-8.64), maternal age over 39 years (OR 3.55, 95% CI: 1.17-10.75), nulliparity (OR 2.72, 95% CI: 1.59-4.66), grand multiparty (OR 3.43, 95% CI: 1.79-6.57), and macrosomia (OR 4.82, 95% CI: 1.49-16.44). There was a weak association with absent or poor. Caesarean delivery is associated with extreme ages of reproductive life, macrosomia, nulliparous and grand multiparous status. We strongly recommend that these factors be taken into consideration to strengthen the mother and child health programs in Cameroon and countries with similar socioeconomic profiles.

[Complications of laparoscopic surgery in gynecology unit A of Yaoundé General Hospital, Cameroon]

The aim of the study was to describe the morbidity and mortality of gynaecological laparoscopy in a pilot center of Cameroon. It was a monocentric retrospective study over a period of seven years. All files of patients who had laparoscopic surgery in the service were reviewed. Files with incomplete information were excluded. Complications were defined as an event that had modified the usual cause of the procedure or of the postoperative period. They were classified as surgical complications (during insertion of Veress needle and trocarts, intraoperative and postoperative complications) also reorganised as major and minor complications and anaesthetic complications. The rate of laparoconconversion was noted. The data of 609 patients was gathered and examined. Their mean age was 31.57 (19-63years). The mean parity and gestity was 0.77 and 1.82, respectively. The common findings in their past history were sexually transmitted infection (39.9%), criminal abortions (35.03%) and previous surgery (39.1%). Infertility was the main indication of the surgery (76.3%) followed by postmyomectomy adhesiolysis (15%). The main operative findings were adhesions (78.16%). The mortality rate is 0.16%. The surgical morbidity rate is 2.46% with 0.99% of complications during insertion of Veress needle and trocarts and 1.48% during surgery. Among these complications, 1.8% were minor complications and 0.66%, major ones. Five patients had complications due to anaesthesia (0.82%). Postoperative complications (8.3%) were of low gravity and were mainly digestive, infectious and moderate vaginal bleeding. The rate of laparoconversion was 2.46%, mainly due to difficulties during surgery. This study shows that operative gynaecologic laparoscopy is associated with acceptable mortality and morbidity rate in our milieu.