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DOI: 10.1055/s-0041-1739736
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
Introduction Obstetric evacuations are a public health probleme in developing Countries.
The objectives of this study were to describe the sociodemographic and prognostic characteristics of evacuated patients.
Patients and method This was a prospective descriptive and analytical study conducted over a 6-month period (April 1 to September 30, 2020) at the maternity ward of Coyah Prefectural Hospital. All patients evacuated for complications of gravidopuerperality were included in the study
Results The frequency of obstetrical evacuations was 3.8%. The average age of patients was 25.22 years with extremes of 15 and 45 years. Housewives (58.82%), nulliparous women (36.93%) and women with no education (64.29%) were the most numerous. No patient received medical transport. More than half of the patients were evacuated by a nurse (51.21%). Hemorrhages in the last quarter were 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 min) with extremes of 20 min and 300 min (5 h). Maternal case fatality was 5.95%. The perinatal lethality rate was 46.42%. No counter-referral was performed. All of the deceased patients had driven more than30 km of difficult road with a statistically significant difference.Newborns of Women transported by motorcycle taxis (2-wheeled vehicles), having benefited from less than 3 antenatal consultations, nulliparous women having traveled a distance of more than 30 km were the most affected with a statistically significant connection.
Conclusion The obstetrical prognosis of evacuated women is still poor. We recommend the establishment of an obstetrical SAMU system in rural areas in order to contribute to the regulation of obstetrical evacuations, but especially to allow low-income patients to have access to the service.
Publication History
Article published online:
26 November 2021
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