Morbidity and Mortality Related to Obstetrical Evacuations in a Country with Limited Resources: The Case of the Maternity Ward of the Prefectural Hospital of Coyah, Guinea
Obstetric complications requiring evacuation are found
all over the world with a high frequency in developing countries where they are
responsible for high fetal-maternal morbidity and mortality. The objectives of this
study were to calculate the frequency of obstetric evacuations in the maternity
ward of the Coyah prefectural hospital, describe the socio-demographic characteristics
of the evacuated patients, identify the main reasons for evacuation, determine the
means of transport used and specify the maternal and fetal prognosis. Patients
and Method: This was a prospective descriptive and analytical study conducted
over a 6-month period (April 1-September 30, 2020) at the maternity ward of the
Coyah prefectural hospital. All patients evacuated for complications of gravidopuerperium
were included in the study. Results: We
recorded 84 cases of obstetric evacuations out of a total of 2206 consultations, i.e. a frequency of 3.8%. The average
age of the patients was 25.22 years with extremes of 15 and 45. Housewives
(58.82%), nulliparous women (36.93%) and women with no education (64.29%) were the
most numerous ones. No patient received medical transportation. More than half of
the patients were evacuated by a nurse (51.21%). Hemorrhage in the last quarter
was the main reason for evacuation. The average distance traveled by patients was
18.3 km with extremes of 12 and 68 km. The average transfer time was 63 min (1 h
3 minutes) with extremes of 20 min and 300 min (5 h). Maternal mortality was 5.95%.
The perinatal mortality rate was 46.42%. No counter-referral was made. Conclusion: The obstetrical prognosis of evacuated women is still poor. We recommend the
establishment of an obstetrical SAMU (UAS) system in rural areas in order to contribute
to the regulation of obstetrical evacuations, but especially to enable low-income
patients to have access to the service.
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