Introduction: Obstetric referrals remain a public health challenge. Objective: To evaluate the prevalence of obstetric referrals in the DASSA-Glazoué health district. Methods: This was a cross-sectional analytical study with retrospective data collection over a five-year period. The study population consisted of women who were referred within the Dassa-Glazoué health district (Zone Hospital and l’Abbraccio Hospital). Women referred between January 1, 2020, and December 31, 2024, were included, while incomplete or unusable medical records of non-referred women were excluded. The sampling exhaustive was used. Data collected on KoboCollect from June 18 to July 20, 2025, were analyzed using Epi Info 7 software. Text and tables were processed using Microsoft Word 2016 and Excel, and Chi-square or Fisher’s exact tests were applied. Informed consent and ethical committee approval were observed. Results: The prevalence of referred women was 29.84%. The mean age was 26.56 ± 6.62 years, ranging from 12 to 48 years. The age groups [24 - 31] years (35.37%) and [17 - 24] years (34.64%) were most represented. The mean parity was 1.87, with pauciparous women (50.52%), primiparous (30.31%), nulliparous (32.44%), and multiparous (27.54%), and the majority resided in urban areas (70.16%). Most referrals came from health centers (91.41%), had a referral form (93.83%), and had intravenous access prior to transfer (74.49%). Transport time was short for 42.20% of cases (arrival within 2 hours), but motorcycles were the main mode of transport (58.77%). The main reasons for referral were inadequacy of technical facilities (46.43%). Severe hypertension/preeclampsia-eclampsia, post-term pregnancy and pain as the reason for admission was significantly associated with an increased risk of mortality (p < 0.001).
References
[1]
WHO (2020) Maternal Health. https://www.afro.who.int/health-topics/maternal-health
[2]
Prual, A. (1999) Pregnancy and Delivery in Western Africa. Towards a Lower Risk Motherhood. Sante Publique, 11, 167-191.
[3]
Leki, T., Bosunga, K., Matumo, P., Kaghoma, A. and Lukangi, D. (2021) Aspects épidémio-cliniques des “Echappees belles” en gravido puerperalite et décès maternel à Bunia. Revue médicale des Grands Lacs, 12, 48-65.
[4]
Tonato Bagnan, J.A., Lokossou, M.S.H.S., Tshabu Aguemon, C., Yessoufou, M.M.A.O., et al. (2017) Les urgences obstétricales à la Clinique Universitaire de Gynécologie et d’Obstétrique (CUGO) du Centre National Hospitalier et Universitaire Hubert Koutoucou Maga (CNHU-HKM) de Cotonou: Aspects épidémiologiques et pronostiques. Journal de la SAGO, 18, 12-16.
[5]
Beňová, L., Semaan, A., Afolabi, B.B., Amongin, D., Babah, O.A., Dioubate, N., et al. (2023) Obstetric Referrals, Complications and Health Outcomes in Maternity Wards of Large Hospitals during the COVID-19 Pandemic: A Mixed Methods Study of Six Hospitals in Guinea, Nigeria, Uganda and Tanzania. BMJ Open, 13, e076364. https://doi.org/10.1136/bmjopen-2023-076364
[6]
Tshabu-Aguèmon, C., Denakpo, J., Adisso, S., Mampassi, E. and de Souza, J. (2012) Maternal and Perinatal Mortality Linked to Obstetric References to the C.U.G.O. of the CNHU-HKM in Cotonou. African Journal of Anesthesioly and Emergency Medicine, 17, 37-43. https://web-saraf.net/Mortalites-maternelle-et.html
[7]
Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A., Daniels, J., et al. (2014) Global Causes of Maternal Death: A WHO Systematic Analysis. The Lancet Global Health, 2, e323-e333. https://doi.org/10.1016/s2214-109x(14)70227-x
[8]
Ghardallou, M., Limam, M., Khelifi, A., Khairi, O., Khairi, H., Mtiraoui, A., et al. (2019) Obstetric Referrals to a Tertiary Care Maternity: A Descriptive Study. Pan African Medical Journal, 33, Article 306. https://doi.org/10.11604/pamj.2019.33.306.16906
[9]
Conté, I., Sylla, I., Baldé, O., Soumah, A.F.M., Baldé, A., Bah, O.H., et al. (2023) Obstetric Emergencies: Frequency, Socio-Demographic Aspects and Risk Factors at the Labe Regional Hospital Maternity Unit (Guinea). Open Journal of Obstetrics and Gynecology, 13, 1849-1858. https://doi.org/10.4236/ojog.2023.1311156
[10]
Takai, I.U., Yusuf, M. and Bashir, H. (2023) Audit of Emergency Obstetric Referrals at a Tertiary Center in Kano. Annals of African Medicine, 22, 265-270. https://doi.org/10.4103/aam.aam_8_22
[11]
Aggarwal, N., Singla, R., Dhaliwal, L. and Suri, V. (2015) Audit of Emergency Obstetric Referrals—A Pilot Study from Tertiary Care Centre of North India. Bangladesh Journal of Obstetrics & Gynaecology, 30, 25-29. https://doi.org/10.3329/bjog.v30i1.30504
[12]
Chavane, L.A., Bailey, P., Loquiha, O., Dgedge, M., Aerts, M. and Temmerman, M. (2018) Maternal Death and Delays in Accessing Emergency Obstetric Care in Mozambique. BMC Pregnancy and Childbirth, 18, Article No. 71. https://doi.org/10.1186/s12884-018-1699-z
[13]
Ssebunya, R. and Matovu, J.K.B. (2016) Factors Associated with Utilization of Motorcycle Ambulances by Pregnant Women in Rural Eastern Uganda: A Cross-Sectional Study. BMC Pregnancy and Childbirth, 16, Article No. 46. https://doi.org/10.1186/s12884-016-0808-0
[14]
Kyei-Nimakoh, M., Carolan-Olah, M. and McCann, T.V. (2017) Access Barriers to Obstetric Care at Health Facilities in Sub-Saharan Africa—A Systematic Review. Systematic Reviews, 6, Article No. 110. https://doi.org/10.1186/s13643-017-0503-x
[15]
Amele, A.G., Mengesha, H.G., Tariku, A., Awoke, Z., Eshetu Helig, L., et al. (2020) Barriers to Access and Utilization of Emergency Obstetric Care at Health Facilities in Sub-Saharan Africa: A Systematic Review. BMC Women’sHealth, 20, Article No. 118.
[16]
Naime-Alix, A.F. (2008) How Long Can We Wait at Full Dilatation. A Study of Maternal and Neonatal Morbidity Related to the Duration of the Second Stage of Labour in Nulliparous Women. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 37, 268-275.
[17]
Okafor, U.V., Efetie, E.R. and Amucheazi, A. (2011) Risk Factors for Maternal Deaths in Unplanned Obstetric Admissions to the Intensive Care Unit-Lessons for Sub-Saharan Africa. African Journal of Reproductive Health, 15, 51-54.
[18]
Duley, L. (2009) The Global Impact of Pre-Eclampsia and Eclampsia. Seminars in Perinatology, 33, 130-137. https://doi.org/10.1053/j.semperi.2009.02.010
