TITLE:
Audit of Obstetric Medical Evacuations at Youssou Mbargane DIOP Hospital in Rufisque, Dakar-Senegal
AUTHORS:
Moussa Diallo, Omar Gassama, Mame Diarra Ndiaye, Mamour Gueye, Astou Coly Niassy Diallo, Aissatou Mbodji, Abdoul Aziz Diouf, Magatte Mbaye
KEYWORDS:
Obstetrical Evacuation, Morbidity, Mortality, AQUASOU
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.8,
August
7,
2019
ABSTRACT: Objectives: To assess the quality of the obstetric evacuation system at the Youssou
Mbargane Diop Hospital in Dakar. Methods: Our study was conducted at the
Hospital of Youssou Mbargane DIOP in Rufisque, a district about 26 km from
downtown Dakar. This was a qualitative and evaluative descriptive study in the
form of operational research aimed at improving the quality of obstetrical
evacuations and resolving problems through a dynamic and team approach. It was
carried out within the framework of the AQUASOU project (Improvement of Quality
and Access to Emergency Obstetric Care in French). A liaison sheet was
completed at the arrival of each evacuated patient, prospectively during the
period from December 24 2006 to July 10 2008. The epidemiological
characteristics were, origin of the evacuated, the evacuation conditions, evacuation patterns
and therapeutic data. The data were collected through an Excel database
developed for this purpose. The analysis was done using the Epi-Info version
6.0 software. Results: The frequency of evacuations was 23.2%. The
average age of our patients was 25.3 years with extremes of 14 years and 48
years. More than half of the evacuees (59%) came from the Sanitary District of
Rufisque. The majority of evacuations were made in a taxi (76.5%). An ambulance
was used in 190 cases (20.6%). Seated transport was performed in 78% of cases.
The transfer was medicalized in almost one-third
of cases (29.3%). A liaison sheet was established during the transfer of
patients in 77% of the cases. Evacuations were related to hemorrhage in 23.3%,
dystocia in 22.2%, and fetal-adnexal anomaly in 17.3% of cases. No treatment
was instituted before evacuation in 56% of evacuees. 48.5% of the evacuees had
received treatment beyond. Conclusion: The poor quality of obstetric evacuations seems to be a brake on the
decline in maternal and neonatal mortality in Senegal. Training and retraining
of health personnel would improve maternal-fetal and neonatal morbidity and
mortality.