Introduction: All pregnant women are at risk of obstetric
complications leading to high fetal-maternal mortality and
morbidity. The aim of this work was to evaluate the maternal and fetal
prognosis of evacuated parturients.Patient and Method: we conducted a prospective analytical survey for four months, from
April 1st to July 31st, 2018 in the Maternity of N’Djamena
Mother and Child Hospital about the maternal and fetal prognosis of evacuated
parturients. Any parturient evacuated or referred for obstetric complications
was included. Study parameters were epidemiological, clinical, para-clinical,
therapeutic and prognosis order. These parameters were analyzed in the SPSS 18
French version software.Results: Evacuated parturients represented 20% of maternity admissions. The
average age was 23.9 years, with extremes ranging from 15 and 43 years. They
were uneducated in 72.9%, primiparous in 46.8% of cases. The three delays were
dominated by the 1st delay, which represented 34.1% of cases. In
this series, 26.3% parturients had presented obstetric complications. Preruptive syndrome was the most common
complication with 29.3% cases. Predisposing factors to maternal-fetal
complications were low attendance antenatal care, late evacuation and distance
travelled. The mater
References
[1]
World Health Organization (2017) Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors. 2nd Edition, World Health Organization, Geneva, 436 p.
[2]
International Federation of Gynecology and Obstetrics (2013) How to Conduct Maternal Death Reviews (MDR) Guidelines and Tools for Health Professionals. 45 p.
[3]
Ministry of Plan and Cooperation (2016) National Institute of Statistics, Economic and Demographic Studies in N’Djamena—Chad Demographic Health Survey and Multiple Indicators Survey in Chad (EDS-MICS) 2014-2015. 231 p.
[4]
Lankoandé, J., Ouédraogo, C.M.R. and Ouédraogo, A. (1997) Obstetric Health Evacuations and Feto Maternal Mortality in Burkina Faso. Tropical Medicine, 57, 311-316.
[5]
Saizonou, J., Ouendo, E.M. and Dujardin, B. (2006) Audit of Maternal Deaths in Four Reference Maternities in Benin: Quality of Emergency Care, Causes and Contributing Factors. African Journal of Reproductive Health, 10, 28-40.
https://doi.org/10.2307/30032469
[6]
Tshabu-Aguèmon, C., Denakpo, J., Adisso, S., Mampassi, E. and de Souza, J. (2012) Maternal and Perinatal Mortality Related to Obstetrical Referrals to the C.U.G.O. of the CNHU-HKM in Cotonou. Review African Anesthesia Emergency Medicine, 17, 43-49.
[7]
Sepou, A., Yanza, M.C., Nguembi, E., Dotte, G.R. and Nali, M.N. (2000) Analysis of Medical Evacuations in Gynaecology and Obstetrics in Bangui, Central African Republic. French Studies Research/Health Notebooks, 10, 399-405.
[8]
Lokoussou, A., Adisso, S., Komongui, D.G., Lantoundji, C., Hounkpatin, B.I. and Perrin, R.X. (2003) Obstetrical References in Emergencies Situations: Prognosis Aspects. African Gynaecology and Obstetrics Society Journal, 2, 213-217.
[9]
Diarra Nama, A.J., Angbo, O., Koffi, M.N., Yao, T.K. and Welfens Ekra, C. (1999) Morbidity and Mortality Related to Obstetric Transfers in the Bouaflé Health District in Ivory Coast. Sante Publique, 11, 193-201.
[10]
Sepou, A., Goddot, M. and Ngbale, R. (2009) Evolution in the Frequency of Problems Related to Medical Evacuations to Gynaecology-Obstetrics Service in Bangui Community Hospital. Clinics in Mother and Child Health, 6, 10-12.
[11]
Thera, T., Traore, Y. and Kouma, A. (2015) Problematic of the Reference and Counter-Reference System of Obstetric Emergencies and Community Implication in Bamako District. Mali Medical, 30, 34-37.
[12]
Berthe, M., Diawara, F., Coulibaly, S., Maiga, B. and Iknane, A.G. (2013) Study of the Relationship between Maternal-Fetal Prognosis at the Distance Travelled and the Mode of Admission in the Keniéba Health District in Mali. Public Health Mali, 3, 84-87.
[13]
Thiam, O., Cissé, M.L. and Mbaye, M. (2013) The Problematic of Evacuated Parturients to Rural Areas in Senegal: Example of Hospital Center in Ndioum. CAMES Health Review, 1, 51-56.
[14]
Cissé, M.L., Raad, B., Diouf, A., Wade, F. and Moreau, J.C. (2010) Record of Obstetric Evacuations in Kolda Hospital. Black African Medicine, 57, 37-43.
[15]
Lompo, K., Hutin, Y.J.F., Traoré, G., et al. (1993) Morbidity and Mortality Related to Obstetric Medical Evacuations in Bobo-Dioulasso Hospital, Burkina Faso. Annal Belgian Medicine Society, 73, 153-163.
[16]
Foumsou, L., Gabkika, B.M., Chingnabo, L., et al. (2016) Analysis of Factors Associated with Avoidable Maternal Deaths in N’Djamena. Mother and Child Hospital in Chad. African Journal of Integrated Health, 6, 13-17.
[17]
Soltani, M.S., Bechir, A. and Souissim, M.B. (1991) Profile of Pregnancies Referred in Tunisian Sahel. French Review Gynecology Obstetrics, 86, 511-513.
[18]
Diallo, F.B., Diallo, A.B., Diallo, Y., et al. (1998) Maternal Mortality and Lifestyle Risk Factors. Black African Medicine, 45, 723-728.
[19]
Solofomalala, G.D., Randriamalalaarijaona, R.T., Rasendramino, M.H., Ratsivalaka, R. and Canonne, F. (2007) Gyneco-Obstetrical Emergencies in a Malagasy District Maternity Hospital. Tropical Review Surgery, 1, 67-70.
