Volume 3 Issue 2
Research Article: Knowledge, Attitudes and Practices of Traditional Birth Attendant on the Recognition of Danger Signs in Pregnancies and the Prevention of Infections
Noa Ndoua C C*, Dohbit S J, Belinga E, Mendibi S, Kasia J M
We report on the results of a survey carried out on 30 Traditional Birth Attendants (TBA) in the littoral region of the Republic of Cameroon. The main objective of this survey was to evaluate knowledge, attitudes and practices of traditional birth attendants with regard to their ability to recognize danger signs during pregnancies and the prevention of infections. The survey did not include trained birth attendants who perform deliveries in homes. The mean age of traditional birth attendants was 49.6 years; the lowest age being 33 and the highest 69. 30% of the matrons were self-made. 19 of them, representing 63.3% had received a given training. All the informants acknowledged having referred parturients even though the practice was only systematic with 40% of them. In all, 56.7 % of the matrons referred parturients during labor and 27.7% before labor. 87% of the matrons interviewed referred patients for convulsions, 63.3% for abundant bleeding, 26.7% for prior history of C-section, 23.3% for fever or when the abdomen was so large. A single matron referred patients when the labor time rose up to 12 hours. No parturient was referred as a result of the loss of the amniotic fluid before labor. Hand washing was systematic for 73.3% of the matrons. Six of them, representing 20% used barriers against infections. They only used glove for this purpose. Generally, water and soap were used to sterilise tools (76.7%). Only 23.3% of TBA systematically directed their patients to health centers upon delivery. Traditional birth attendants being an essential component in reducing maternal and neo-natal in low-income countries ought to be empowered in recognizing danger signs of pregnancies and the prevention of infections.
Cite this Article: Noa Ndoua CC, Dohbit SJ, Belinga E, Mendibi S, Kasia JM. Knowledge, Attitudes and Practices of Traditional Birth Attendant on the Recognition of Danger Signs in Pregnancies and the Prevention of Infections. Int J Reprod Med Gynecol. 2017;3(2): 051-055.
Published: 02 November 2017
Research Article: Survey-Based Assessment of Changes in Provider Attitude towards Fertility Preservation through Targeted Educational Seminars Regarding Iatrogenic Gonadotoxicity Fertility Preservation Options: A Multidisciplinary Approach
Monica Pasternak*, Anjie Li, Katherine Leung MPH, Julia Johnson and Lubna Pal
Objective: To evaluate the utility of a targeted lecture in improving FP awareness amongst clinicians.
Design: This is a dual institution, prospective survey-based study assessing if an educational lecture can increase the likelihood of FP consideration, discussion, and referral.
Setting: University of Massachusetts and Yale-New Haven Hospital
Patients: N/A a total of 147 pre- and post-lecture surveys were collected and analyzed.
Intervention: A lecture-style educational session providing information regarding Fertility Preservation (FP) options is effective in imparting FP knowledge to clinicians.
Main Outcome Measures: Pre- and post-lecture survey evaluating clinician-perceived practice patterns were addressed with questions regarding consideration of, discussion of and referral for fertility preservation.
Results: 81.2% of clinician respondents reported their patients rarely or never initiate FP discussion. Post-lecture, the likelihood of respondents to consider FP increased from 12.5% to 58.5% (p < 0.001), likelihood to initiate discussion increased from 10.0% to 49.0% (p < 0.001), and likelihood to refer increased from 61.1% to 82.0% (p < 0.001). At baseline, respondents were most familiar with IVF and embryo cryopreservation (84.0%) with only 4.8% of respondents reporting familiarity with radical trachelectomy. Afterwards, familiarity with all methods increased: IVF 96.6%, oocyte cryopreservation 91.8%, tissue cryopreservation 88.4%, GnRH analogs 88.4% and radical trachelectomy 69.4%.
Conclusions: It is important for clinicians to initiate FP discussion, as patients are unlikely to initiate it themselves. A lecture is effective at imparting FP knowledge to clinicians. This simple strategy increased the likelihood that clinicians will consider and discuss FP with appropriate patients, and increased the likelihood they will refer appropriate patients to fertility specialists.
Cite this Article: Pasternak M, Li A, Katherine Leung MPH, Johnson J, Pal L. Survey-Based Assessment of Changes in Provider Attitude towards Fertility Preservation through Targeted Educational Seminars Regarding Iatrogenic Gonadotoxicity Fertility Preservation Options: A Multidisciplinary Approach. Int J Reprod Med Gynecol. 2017;3(2): 043-050.
Published: 13 October 2017
Short Communication: Pelvic Lymphadenectomy-an Essential Part of Surgical Treatment of Cervical Cancer
In Bangladesh, the incidence of cervical cancer is about 13,000 and around 6600 women dies from cervical cancer each year . Cervical cancer constitutes 22-29% of the female cancer in Bangladesh [2,3]. Diagnosis and treatment of CIN through population-based screening programs has lead to 50-80% reduction in deaths from cervical cancer in various developed countries .
Cite this Article: Khatun S. Pelvic Lymphadenectomy-an Essential Part of Surgical Treatment of Cervical Cancer. Int J Reprod Med Gynecol. 2017;3(2): 040-042.
Published: 05 October 2017
Research Article: Outcome of Pregnancy in Pre-Eclampsia and Eclampsia at the Regional Hospital Maroua-Cameroon
Pierre-Marie Tebeu*, Gregory Halle, Jean Dupont Kemfang Ngowa, Joel Fokom Domgue, Clovis Ourtching and Emile Mboudou
Background: We conducted this study to identify outcomes of pregnancies complicated by pre-eclampsia and eclampsia in Cameroon.
Methods: This was a cohort study at the Regional Hospital, Maroua-Cameroon between June 2005 and May 2007. The outcome of pre-eclamptic and ecliptic patients were compared. The level of significance was 0.05.
Results: Among the 152 patients, 6 maternal deaths were recorded leading to the overall case fatality rate of 3.9%; with 5 out of 56(8.9%) and 1 out of 96 (1%) maternal deaths in the eclamptic and pre-eclamptic groups respectively. Eclampsia was associated with an increased risk of delivery by caesarean section (Odds Ratio [OR]: 3.3, 95% CI: 1.3-8.2, P = 0.0173) and maternal death (OR: 9.3, 95% CI: 1.05-81.8, P = 0.0160).
Foetal death was 18% among the eclamptic patients, compared to 32% among the pre-eclamptic patients leading to the overall 26.6% foetal death.
Among patients with Eclampsia, induction of labour was associated with an increased risk of foetal death (Odds Ratio [OR]: 6.3, 95% CI: 1.02-38.2, P = 0.0296).
Conclusion: In Maroua, outcome of hypertensive disorders in pregnancy still dramatic. The national priority guidelines, education, training and supply of the drug in the management of eclampsia and severe pre-eclampsia are required.
Cite this Article: Tebeu PM, Halle G, Kemfang Ngowa JD, Domgue JF, Ourtching C, et al. Tebeu's Outcome of Pregnancy in Pre-Eclampsia and Eclampsia at the Regional Hospital Maroua-Cameroon. Int J Reprod Med Gynecol. 2017;3(2): 034-039.
Published: 27 September 2017
Research Article: Tebeu's Pronostic Classification of Obstetric Fistula According to Anatomopathologic Variables from the University Teaching Hospital, Yaounde Cameroon
Pierre Marie Tebeu*, Georges Didier Ngassa Meutchi, Claude Cyrille Noa Ndoua, Yvette Nkene Mawamba, Gregory Halle Ekane and Charles Henry Rochat
Introduction: Several studies revealed the prognostic value of the fistula location, size and the vaginal fibrosis on surgical result.
Objective: We conducted this study in order to evaluate a surgical outcome of Obstetric vesicovaginal fistula focusing on three leading prognostic factors combination including size, location and softening of surrounding tissue.
Methods: This was a retrospective case series study from 69 patients at the University Teaching Hospital, Yaounde, Cameroon involving patients operated from March 2009 to March 2015.
We collected data from registers, patient's folders and by phone call. We defined criteria of good prognosis based on the 3 prognostic factors (retrotrigonal location, size < 2 cm, soft vagina tissue); minor criteria of poor prognosis (bladder wall other than retrotrigonal, size between 2-4 cm, vagina less scaring); and major criteria of poor prognosis (Complete circumferential defect, size > 4 cm, major scaring/stenosis).
The combination of the above variables helped in defining prognostic classes as, class-I (3 criteria of good prognosis); class-II (1 minor criteria of bad prognosis); class-III (2 minor criteria of bad prognosis); class-IVA (3 minor criteria of bad prognosis, or 1 major criteria of poor prognosis), and class-IVB ( at least 2 major criteria of bad prognosis ). Closure with continence rate was assessed at discharge, and at 3 months after surgery.
Results: Obstetric fistula frequency was respectively class I (18.8%), class II 53.7%), class III (18.8%) and class IV (8.8%). The satisfactory result decreased from class I to IV as closure with continence rate were, respectively for class I (92.3%), class II (94.6%), class III (77%) and class IV (16.7%).
Conclusion: Fistula location, size and softening of surrounding tissue provide a promising prognostic classification of obstetric fistula in four entities. While waiting for additional researches this appears as a good field option.
Cite this Article: Tebeu PM, Ngassa Meutchi GD, Noa Ndoua CC, Mawamba YN, Ekane GH, et al. Tebeu s Prognostic classifi cation of obstetric fi stula according to anatomopathologic variables at the University Teaching Hospital, Yaounde, Cameroon. Int J Reprod Med Gynecol. 2017;3(2): 029-033.
Published: 22 September 2017
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