TITLE:
Problem of Obstetrical Evacuations: About 630 Cases Collected at the Maternity of Bouake University Hospital
AUTHORS:
Lydie Estelle Djanhan, Jean Marc Dia, Messou Michelle Menin, Yaya Samaké, Claussen M’broh, Kouadio Narcisse Kouadio, Kouamé Privat Kouakou, Yacouba Doumbia
KEYWORDS:
Obstetric Emergencies, Evacuations, Reference, Maternal Mortality
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.3,
March
30,
2018
ABSTRACT: Objective: To improve the care of evacuees at the maternity of the University
Hospital Center of Bouaké (CHUB). Methodology: This is a cross-sectional and descriptive study over a period of three
months that covered 630 cases collected at the Maternity of the university Hospital of Bouaké. Results: Obstetric evacuation
accounted for 42.5% of admissions to the delivery room. Patients under 20 years
and over 34 years of age respectively represented 21% and 13.5% of the total.
62.7% of evacuees were not educated and 84.9% had low economic level.
Nulliparous and multiparous women accounted for 54.9% of the patients and 88%
had mean prenatal follow up. The evacuations were decided by midwives (91.3%), without previous
adapted treatment (79.4%), with a badly filled evacuation card (49.7%) and no
partograph. The
taxi was the most used means of transportation (75.2%) and most evacuees took
less than one hour to access the referral center (61.4%). The reasons for evacuation
are mainly dominated by mechanical obstructions (34.8%); on admission the
evacuees with no real reference reason were 243 (38.6%) and the diagnosis was
inconsistent in 43% of cases. The
majority of evacuated women delivered vaginally (69.4%). Most newborns had a
satisfactory state at the 5th minute of life (79.4%) and we noted 54 cases
(08.3%) of neonatal deaths. 7.8% of evacuees had a complication dominated by
postpartum anemia (51.1%); we had lamented 17 cases (2.7%) of maternal deaths
among evacuees, attributable to delivery haemorrhage (47.1%) and eclampsia
(23.5%). Conclusion: A better organization of the reference and an equipment of the
peripheral health structures would improve the prognosis of the evacuees.