Dépistage Opportuniste des Lésions Cervicales Pré-Invasives et du Cancer du Col chez la Femme Enceinte Camerounaise

Résumé

ABSTRACT Objectif. Au Cameroun  62.9%  des cas de cancer du col sont diagnostiques a un stade avance. Cette situation pourrait etre amelioree en multipliant les opportunites de depistage. Afin de Le but de notre etude etait de decrire la prevalence de la cytologie cervicale anormale pendant la grossesse et le post-partum Methodologie. Il s'agissait d'une etude transversale et descriptive. Nous avons releve dans les services d’anatomopathologie les resultats des frottis cervico uterin, faits chez des patientes enceintes ou en post- partum de Janvier 2010 a Decembre 2012, au centre hospitalier d’Essos, au centre hospitalier universitaire de Yaounde et a l’ hopital gyneco obstetrique et pediatrique de Yaounde. Resultats. 252 frottis cervico uterin ont ete enregistes; 173 ont ete realises chez des femmes enceintes et 79 chez des femmes en post-partum. Pour 235 (93,6%) des patientes incluses ces frottis cervico uterin etaient les tous premiers. Les Frottis cervico uterin en grossesse ont ete fait avant 22 semaines d’amenorrhee dans 68,7% des cas. Aucune fausse couche ni menace d’avortement, ni accouchement premature n’a ete observe. 6,3% (16) des frottis ont mis en evidence des dysplasies du col uterin: 4% d’Atypies des cellules malpighiennes de signification indeterminee (ASC-US) et 2,4% de lesions malpighiennes intraepitheliales de bas grade (LSIL). Aucune lesion de haut grade ni de cancer n’a ete diagnostique. Conclusion. Au Cameroun, le depistage du frottis vaginal pendant le bilan de grossesse et le puepuerium peuvent offrir de nombreuses opportunites d'optimiser la prevention du cancer du col de l'uterus. RESUME Objective.In Cameroon, 62.9% of cervical cancer are diagnosed in the latest stage of the disease. This may be different if opprotuiies of screening were multiplied. The aim of our study was to describe the prevalence of abnormal cervical cytology in pregnancy and post-partum. Methods.  This was a cross sectional retrospective and descriptive study. Data of interest were the type and grade of cervical epithelial lesions observed on pregnant or post-partum women received at the Essos hospital center, the University Teaching Hospital of Yaounde and The Yaounde Gynecology, Obstetrics and Pediatrics Hospital, from January 2010 to December 2012. We collected datas from the Cervico-Vaginal pap smear Registars regarding to the Bethesda System. Results.  252 women were screened with conventional Pap smear.  Among the 252 women, 173 were pregnants and 79 were in post partum. 162 (64.3%) were between 16 and 31 years olds. 235 (93.6%) women have never had a pap smear in the past. Conventional Pap smear was taken at < 22 weeks of gestation in 68.7% of cases. No miscarriage nor threatened abortion or premature delivery was observed. The prevalence of cervical dysplasia was 6.3% (16); 4% Atypical squamous cells of undetermined significance and 2.4% Low-grade squamous intraepithelial lesion. No high grade squamous intraepithelial lesion, nor cancer was observed. Conclusion. Pap smear screening during pregnancy workup and puepuerium may provide opportunities to optimized cervical cancer prevention in Cameroon.

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