DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205212

Obstetric emergencies in the maternity ward of the Ignace Deen national hospital CHU of Conakry: sociodemographic, therapeutic and maternal fetal prognosis aspects

Ibrahima S. Balde, Ousmane Baldé, Ibrahima Sylla, Ibrahima T. Diallo, Alhassane I. I. Sow, Alpha B. Barry, Thierno M. D. Bah

Abstract


Background: Despite government efforts to reduce maternal mortality, the risk of a woman dying from obstetric complications is about one in six in the poorest regions of the world compared to one in thirty thousand in North Europe. The objective was therefore to describe the clinical socio-demographic aspects and to establish the maternal and fetal prognosis of obstetric emergencies.

Methods: This was a descriptive cross-sectional prospective study over a 6-month period from January 1 to June 30, 2020 carried out at the maternity ward of the Ignace Deen national hospital (Conakry university hospital) in Guinea. The study looked at a continuous series of 662 obstetric emergency cases.

Results: The frequency of admission of obstetric emergencies was 22.62%. They concerned young women (29.5 years old) on average, first-time mothers (53.32%), with low income professional activities, evacuated from a peripheral maternity unit (63.14%), no schooling (44.9%), married (92.3%), using the more often a means of public transport (66.5%) and whose pregnancies were poorly monitored (63.9%). Fetal emergencies were dominated by acute fetal distress (91.3%) and maternal emergencies were dominated by hypertensive emergencies (pre-eclampsia and eclampsia 37.44%) followed by hemorrhagic emergencies (last trimester hemorrhage and postpartum hemorrhage 34.34%). Pregnant and parturient women were more frequently admitted to labor (62.7%) and gave birth more frequently by caesarean section (86.70%). the staff reacted promptly to make a treatment decision in 75.5% of cases within fifteen minutes. emergency procedures were performed in less than fifteen minutes in almost all cases (97.4%), specific treatment was carried out in less than an hour in the majority of cases (68.3%). The maternal case fatality rate was 4.1% with the main cause of death being hemorrhagic shock of 51.8%. The stillbirth rate was 17.4%.

Conclusions: The anticipation of emergency obstetric care (SOU) and close collaboration between the obstetrician, the anesthesiologist-resuscitator are essential in the management of obstetric emergencies.


Keywords


Obstetric emergencies, Socio-demographic, Clinical, Treatment, Prognosis, Guinea

Full Text:

PDF

References


Bayoma BM. Study of the frequency of obstetric emergencies at the Kamina referral hospital, public health licenses. Kamina University DRC. 2011;55.

Coulibaly D. Epidemio clinical study of obstetric emergencies at the reference health center of commune IV about 293 cases thesis, Bamako university, faculty of medicine Pharmacy and odontostomatology, Mali. 2007.

Oms. Summary report of the launch of the guideline for clinical practice in emergency obstetric and neonatal care in Africa. Bamako, Mali. 2009.

Foun L, Lokossou, Fayoni EB, Yacoubi M. Preventable maternal mortality in a hospital environment in a department in Benin. Black Afri Med. 2000;47(1).

Walker D, Cohen S, Fritz J, Olivera M, Lamadrid-Figueroa H, Greenberg-Cowan J et al. Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico, impact on process indications, biomed central. 2014,14:367-78.

Pacha O, Goldenberg RL, Mc Clure ME, Saleem S, Goudars S, Althabe F et al. Communities birth attendants and health facilities a continuum of emergency maternal and new born care (the global network’s emonc triol). Bio Med Cent Pregn Chi Birth. 2010;10;82-91.

Fritz J, Lamadrid-Figueroa H, Angels G, Montoya A, Walker D. Health providers pass knowledge and abilities acquired by training in obstetric emergencies to their peers; the average treatment on the treated effect of pronto on delivery attendance in Mexico. Biomed Central Pregn Child Bi. 2018;18:232-40.

Bouvier-Colle MH, Philibert MM. Epidemiology of maternal mortality in France, frequency and characteristics. Réanimation. 2007;16:358-65.

Marianne P, Botsbras F, Mariehelene Bouvier C. Epidemiology of maternal mortality in France, frequency, factors and causes. Weekly epidemiol bulletin France. 2006;50.

Dissa L. Epidemiological-clinical study of obstetric emergencies at the reference health center of commune V from 2002-2003 about 1265 cases, thesis, University of Bamako, faculty of medicine, pharmacy and odonto stomatology Mali. 2005.

Bagnan TJA, Lokossou MSHS, Agemon TC, Yessoufou MMAO, Adisso S, Lokossou A et al. Obstetric emergencies (CUGO) of the national hospital and university center Hubert Koutoukou Maga (CNH HKM) in Cotonou: epidemiological and prognostic aspects. SAGO J. 2017;2(18);1-10.

Lokossou MSH, Agoudjobiom, Toguifode V, Adissos, Ali A et al. The etiologies of obstetric emergencies in the maternity ward of the departmental university hospital of L’ouemé-plateau (CHUDOP) in BENIN. J Bio Clin Soc. 2016;27;52-8.

Masala BB. study of the frequency of obstetric emergencies at the general referral hospital of Kamina DRC University of Kamina DRC license in public health. 2011.

Mutombo C. Mumbamukandilaa, Mikenji BJ.: Profile and prognosis of obstetric emergencies in the labor ward of the bonzola maternity unit in Mbuji-Mayi. Mali med. 2015;30(4):65-73.

Tsonga MS, Akovo L, Ngou, Mve-Ngou JP, Meye JF. Risk factors for Libreville eclampsia (GABON), case-control studies, study book, and French-speaking/health Res. 2006;16:197-200.

Oliveira Jr FC, Costa ML, Cecahi JG, Silva PJL, Surita FG. Maternal morbidity and near miss associated with maternal age; the innovation approach of the 2006 BRAZILIAN demographic health survey clinics. 2013;68(7):922-7.

Aguemon TC, Denakpo J, Adisho S, Possi ME, DE Sonza J. Maternal and perinatal mortality linked to the obstetric references of CUGO of the HKM of Cotonou. Except RAMUR tome. 2012;17(1):1-6.

Otiobanda GF, Mahoungou-Guimbi KC, Itona C, Ellenge Mbolla FB, Soussa RG. morbidity and mortality during pregnancy and surgery in a multi-purpose intensive care unit. SARAUF ramur tome. 2012;17(2).

Blaise AT, Nouessewa, Salifou FM HP, Zounmenon E, Chobli M. Obstetric emergencies at the PARAKOU university hospital in Benin, clinical, therapeutic and progressive aspects. Eur sci J. 2015;11(9):260-72.

Kouakou P, Djanhan Y, Doumba Y, Djanhan L, Ouatara M. In Uterine ruptures, epidemiological aspects and maternal fetal prognosis at the Bouake CHU maternity unit, Edition CAMES-sene A. vol 05 Cote d'Ivoire. 2017.

OMS. WHO recommendations for prenatal care for a positive pregnancy experience WHO/RHR/16.12. 2016;9.

Dumas AM, Bertrand M. Hemorrhage at the start of labor: leads to hold. Lansac J. Body G, Perrotin F and Marr and H (EDS) practice of childbirth, Masson edition, Paris. 2001;303.

Ouadraogo C, Testa J, Sondob, Kone B. Analysis of risk factors for severe maternal morbidity in Ouagadougou, Burkina Faso. Black Afr Med. 2001;48.

El Béchir M, El Diyans ME. The prevalence of caesarean section at the regional hospital of zonerate, University of Nouakchott. 2011.

Organisation mondiale de la sante. Beyond the Numbers, Examining Maternal Deaths and Complications to Reduce Pregnancy Risks Geneva. 2004;155.

Belghiti A, De Bronwere V, Vanlerberghe W. Monitoring un met obstetric need at district level in morocco. Trop. Med Int Health. 1998;3:584-91.

Bouvier-Colle MH, Hetton F. Measurement of maternal mortality. Difficulties and evolution over the past twenty years. In Bouvier-Colle MH, Vamoux N, Bréart G (eds). Maternal deaths in France. Analyzes and prospective. Paris. Inser M. 1994;7-22.