Obstetric complications are the main cause of mortality and morbidity. Many factors limit women’s access to the quality care they need to reduce this mortality. We proposed to analyse our referral system to identify ...Obstetric complications are the main cause of mortality and morbidity. Many factors limit women’s access to the quality care they need to reduce this mortality. We proposed to analyse our referral system to identify certain factors that may limit its proper functioning and contribute to maternal deaths. This was a 12-month descriptive and analytical cross-sectional study of 259 evacuated women. The average age was 28.8 ± 7 with extremes ranging from 15 to 44 years. Most of the women were single (81.5%), accompanied by medical staff (78.8%), and had a venous approach (81.9%). The means of transfer used were ambulance (78.8%) and motorbike (11.6%). The transfer time was less than one hour (40.9%). The reasons for referral were consistent with the definitive diagnoses (64.5%) and diagnostic errors were noted (35.5%). The majority of patients were treated surgically (77.6%). We recorded maternal death (7.7%), due to unqualified personnel, transfer time, and poor general and haemodynamic condition (P < 0.05). The causes of death were abortion, ectopic pregnancy, arterial hypertension and post-partum haemorrhage (P = 0.014). Fresh stillbirths (14.9%), newborns transferred to neonatology (57.7%). Counter-referrals were assured (46.7%). Reducing diagnostic errors and late evacuations, as well as ongoing training for providers in peripheral health facilities on the signs of serious obstetric and neonatal emergencies will help to reduce the frequency of evacuations.展开更多
Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing c...Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing countries. Objective: To identify the determinants that contribute to maternal morbidity and mortality in the Gynaecology and Obstetrics Department of the University Community Hospital. Methodology: We conducted a retrospective study from 1 January 2015 to 31 December 2019 (5 years) in the obstetrics and gynaecology department of the Centre Hospitalier Universitaire Communautaire (CHUC). It focused on the determinants of maternal mortality. Our study population consisted of all women who died during the period and met the World Health Organization (WHO) definition of maternal mortality (MOMA). We used non-probability sampling with the exhaustive choice technique. Results: The study revealed that the number of deaths recorded was 98, while 17,172 live births were registered during the same period. The maternal mortality ratio was 570 per 100,000 live births. The most common age group was 20 to 24, with an average age of 26. The frequency of death among primiparous women was 37.74%, pauciparous women 28.30% and multiparous women 26.42%. Direct causes were dominated by abortion complications (22.41%), followed by infections (9.30%) and haemorrhage (8.19%). Indirect causes were dominated by anaemia with a proportion of 45.16%. The majority of maternal deaths occurred in the post-partum period (34.71%). Most maternal deaths occurred after vaginal delivery, 19 cases (63.33%), while 11 deaths (36.66%) occurred after caesarean section. The occurrence of direct causes was associated with age less than or equal to 25 years, abortion complications and primiparity, with a statistically significant difference. Conclusion: At the end of this study, complications of unsafe abortion and poverty are all factors contributing to the rise in the maternal mortality rate. Emphasis should be placed on promoting family planning, as this would make a major contribution to reducing maternal mortality.展开更多
文摘Obstetric complications are the main cause of mortality and morbidity. Many factors limit women’s access to the quality care they need to reduce this mortality. We proposed to analyse our referral system to identify certain factors that may limit its proper functioning and contribute to maternal deaths. This was a 12-month descriptive and analytical cross-sectional study of 259 evacuated women. The average age was 28.8 ± 7 with extremes ranging from 15 to 44 years. Most of the women were single (81.5%), accompanied by medical staff (78.8%), and had a venous approach (81.9%). The means of transfer used were ambulance (78.8%) and motorbike (11.6%). The transfer time was less than one hour (40.9%). The reasons for referral were consistent with the definitive diagnoses (64.5%) and diagnostic errors were noted (35.5%). The majority of patients were treated surgically (77.6%). We recorded maternal death (7.7%), due to unqualified personnel, transfer time, and poor general and haemodynamic condition (P < 0.05). The causes of death were abortion, ectopic pregnancy, arterial hypertension and post-partum haemorrhage (P = 0.014). Fresh stillbirths (14.9%), newborns transferred to neonatology (57.7%). Counter-referrals were assured (46.7%). Reducing diagnostic errors and late evacuations, as well as ongoing training for providers in peripheral health facilities on the signs of serious obstetric and neonatal emergencies will help to reduce the frequency of evacuations.
文摘Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing countries. Objective: To identify the determinants that contribute to maternal morbidity and mortality in the Gynaecology and Obstetrics Department of the University Community Hospital. Methodology: We conducted a retrospective study from 1 January 2015 to 31 December 2019 (5 years) in the obstetrics and gynaecology department of the Centre Hospitalier Universitaire Communautaire (CHUC). It focused on the determinants of maternal mortality. Our study population consisted of all women who died during the period and met the World Health Organization (WHO) definition of maternal mortality (MOMA). We used non-probability sampling with the exhaustive choice technique. Results: The study revealed that the number of deaths recorded was 98, while 17,172 live births were registered during the same period. The maternal mortality ratio was 570 per 100,000 live births. The most common age group was 20 to 24, with an average age of 26. The frequency of death among primiparous women was 37.74%, pauciparous women 28.30% and multiparous women 26.42%. Direct causes were dominated by abortion complications (22.41%), followed by infections (9.30%) and haemorrhage (8.19%). Indirect causes were dominated by anaemia with a proportion of 45.16%. The majority of maternal deaths occurred in the post-partum period (34.71%). Most maternal deaths occurred after vaginal delivery, 19 cases (63.33%), while 11 deaths (36.66%) occurred after caesarean section. The occurrence of direct causes was associated with age less than or equal to 25 years, abortion complications and primiparity, with a statistically significant difference. Conclusion: At the end of this study, complications of unsafe abortion and poverty are all factors contributing to the rise in the maternal mortality rate. Emphasis should be placed on promoting family planning, as this would make a major contribution to reducing maternal mortality.
