DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175825

Problem of obstetrical evacuations of patients coming from maternities outside the coverage zone of the university and hospital center of Treichville (Abidjan-Côte d’Ivoire)

Jean Marc Dia, Edouard Nguessan, Mohamed Fanny, Mouhideen Oyelade, Gerard Okon, Privat Guie, Simplice Anongba

Abstract


Background: In developing countries, the organization of obstetrical evacuations is experiencing real problems causing certain preventable maternal and fetal morbidity and mortality. Objective of present study was to describe the sociodemographic characteristics and conditions of transfer of patients from peripheral maternities not dependent on the health coverage zone of the University and Hospital Center of Treichville (called maternity out of zone).

Methods: This is a prospective and descriptive study, conducted at the maternity of the University and Hospital Center of Treichville, from 1st August 2012 to 31st July 2014 about 266 patients evacuated from maternity out of zone.

Results: Only 30% of the patients had properly documented evacuation records. Patients had an average age of 26.9 years, poor follow-up of their pregnancy (92.1%), and were generally low socio-economic level: without monthly income (61.7%), not attending school (35.3%). The majority of evacuations were decided by midwives (60.9%) and were done by taxi (69.5%). In 71.4% of the cases, the patients were re-evacuated to our department with the main reason for the unavailability of the operating rooms (84.3%). 46.6% of the patients took more than 3 hours to arrive in our department and 35% arrived in an aggravated condition and sometimes without venous routes. In our department, complications occurred in 27.1% of the patients, and maternal and fetal death rates were respectively 1.5% and 21.3%.

Conclusions: This study revealed malfunctions encountered during evacuations: unsafe transportation, transfer card misinformed, long transfer time.


Keywords


Indicators, Long transfer time, Obstetrical evacuations, Transfer card misinformed, Unsafe transportation

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References


Cissé ML, Raad B, Diouf A, Wade F, Moreau JC. Assessment of obstetrical evacuations to the regional hospital of Kolda (Senegal). Med Afr Noire 2010;5701(1):37-43.

Ekoundzola JR, Buambo SF, Nkihouabonga G. About 204 parturient referred on the Center Hospital and University of Brazzaville. J SAGO 2003;4(2):1-5.

Sepou A, Goddot M, Ngbale R, Gaunefetc CE, Domande M, Fandemae E, et al. Evolution of frequency and problems related to medical evacuations to the Gynecology and Obstetrics Department of the Bangui Community Hospital. Clin Mothers Child Health 2009;6(1):1007-12.

Society of Obstetricians and Gynecologists of Canada. Statement on Wait Times in Obstetrics and Gynecology. J Obstet Gynaecol Can. 2008;30(3):258-70.

Diarra AJ, Angbo O, Koffi MN, Koffi MK, Yao TK, Ekra WC. Morbidity and mortality due to the obstetrical transfers in the sanitary district Bouaflé in Côte d’Ivoire. Health Pub. 1999;11(2):193-201.

Prual A, Bernis DEL, El Joud OD. Potential role of prenatal care in reducing maternal and perinatal mortality in sub-Saharan Africa. J Gynecol Obstet Biol Reprod. 2002;31(1):90-9.

Ouédraogo C, Zoungrana T, Dao B, Dujardin B, Ouédraogo A, Thieba B, et al. Quality caesarean section at the Yalgado Ouagadougou Hospital Center in Ouagadougou. Analysis of the determinants of 478 cases collected in the Obstetrics and Gynecology Department. Med Afr Noire. 2001;48:443-50.

Lompo K, Hutin YJF, Traore G, Tall F, Schmid GJB. Morbidity and mortality related to obstetric care evacuations at the Bobo-Dioulasso Hospital, Burkina Faso. Ann Soc Bel Med Trop. 1993;73(2):153-63