TITLE:
Assessment of Obstetric Evacuations: Received during the Year 2020 at the Touba Ndamatou Public Health Hospital Establishment
AUTHORS:
Babacar Biaye, Mouhamadou Wade, Daba Diop, Abdou Karim Diallo, Mor Ndiaye, Alioune Diop, Awa Ndiaye, Mamadou Sene, Abdoul Aziz Diouf, Mamour Gueye
KEYWORDS:
Evacuation, Pregnancy, Senegal
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.6,
June
28,
2022
ABSTRACT: The counter-referral system is particularly
important for care during pregnancy, childbirth and the post-partum period as
it facilitates access to emergency obstetric and neonatal care. It allows
people to access care that is not likely to be provided at the base and to
manage certain complications arising in
emergency settings. We therefore looked at the evaluation of obstetric evacuations from the Touba Ndamatou public
health. Methodology: This was a retrospective study of
descriptive and analytical type extending over a period of 12 months from
January 1, 2020 to December 31, 2020 at the public hospital health
establishment (PHHE) of Touba Ndamatou. Results: One thousand five hundred and sixty (1560) patients
evacuated for obstetrical reasons were collected out of a total
admission of 5560, i.e., a frequency
of 28%. The average age of the patients was 25.54 years. The mean gestation was
3.24 pregnancies. The average parity was 3.04 deliveries. Almost all of our
patients (99%) were married. Slightly more than one in two women (53.6%) had performed at least 2 or 3 Prenatal
consultations. 80% of parturients had traveled
a distance of less than 20 km. 623 patients came by their own means (54.6%). Evacuation was provided by an ambulance
in 509 patients, i.e., 44.6%. Arterial hypertension and its complications were
the frequent reason for evacuations with approximately one in four
patients (26.2%). Only 3.6% of patients had qualified personnel on board being
evacuated. In our series, 13 deaths were recorded, i.e., 1.1% of cases. The distance traveled seemed not to influence
the future of the mother (p = 0.51). The non-accompaniment of the patient during the evacuation by a medical staff
seemed to influence the prognosis of the mother (p = 0.031). Fetal
morbidity was higher among evacuees not accompanied by medical personnel. The
state of apparent death was observed in the majority of cases in patients
received over a distance of more than 20 km. Conclusion: Evacuation
requires a clear definition of the roles and responsibilities of each level of
the health pyramid, good organization in the health structures as well as
within the community, and a good information system.