We recorded 1853 women including 88 referrals/evacuations, i.e. a frequency of 4.75%. The age group between 15 - 19 years old was the most represented with a frequency of 39.77%. Housewives accounted for 90.90% and they were sonrhaïs in 60.23%. Most of them came from community health centers, i.e. 78.75%. The cart was the most used means of transport, with a rate of 45.45%. These epidemiological aspects are presented in Table 1 .

Nulliparous women are the most represented with a frequency of 27.27%. The scarred uterus was the most represented with 6.81% and 52.27% of parturients did not have any ANC. Term parturients were the most represented with a frequency of 85.23% and 62.50% of our women were referred or evacuated by nurses and 44.32% of our women were referred or evacuated without an accompanying health worker. 56.82% of parturients did not have a partograph on admission. HRP was the most represented motif with a frequency of 22.72%. Placenta previa was the most common diagnosis with a frequency of 20.45%. In 70.45%; There was a concordance between the reference reason and the diagnosis made. These clinical aspects are summarized in Table 2 and Table 3 .

The majority of our patients, 70.45%, were caesarean section and 84.10% of children were alive. A little more than half of the workforce, i.e. 51.14% of parturients, took more than 2 hours to be evacuated. The care was provided in less than 1 hour for 70.45% of our parturients and 36.37% had traveled more than 45km. The duration of hospitalization of 3 days was the most represented with a frequency of 50% and 4.54% of our women had anemia and 93.18 of our women had no complications. The maternal mortality ratio was 6.82%. These therapeutic and prognostic aspects are presented in Table 4 and Table 5 .

The frequency of obstetric emergencies was 4.75% out of a total of 1853 patients registered in 12 months. This frequency can be explained by the size of its population of 681,872 inhabitants on the one hand and by the size of its health area (40 health areas) on the other. Our frequency is slightly lower than those of Sidibe D. [6] : 17.15% and Dougnon F. [7] : 28.5%. This gradual decrease in emergencies is evidence of an improvement in socio-health infrastructure, including the creation of new community health centres, the fairly correct application of the referral/evacuation system at the local level, and capacity building to reduce maternal-fetal mortality. The young age of the majority of our patients could be related to early marriage leading to the occurrence of early pregnancies in a context of physical immaturity, thus confirming the progressive increase in mechanical dystocia. They were married in 85.23% of cases and 90.90% were housewives. The majority of our women marry early.

Nulliparous women represent 27.27% in our study. Large multiparous women represent 23.86%. The risk in these women is due to the fragility of the uterus following multiple and close pregnancies [8] . Our rate is close to that of SIDIBE D. [6] : 23.71%, but higher than that of Thiero M. [9] : 11.9%. In 52.27% of cases, women had had a prenatal consultation and 3.41% had had more than 4 antenatal consultations. This rate is lower than that of Coulibaly M [10] who found a rate of 52.9%. Lack of monitoring during pregnancy and poor quality of ANCs are thought to be a clear risk factor during pregnancy and delivery. The distance traveled varies from 2 to 90 km in our study. This result is lower than that found by Macalou B. [11] whose extremes are from 2 to 250 km but higher than the Alamine rate [12] whose extremes are from 1 to 20 km. Our result is in line with the status of a reference health center. The cart is the most frequently used means 45.45%. This rate is slightly lower than that of Coulibaly M [10] 74% but significantly higher than the levels of Alamine [12] (0.8%) and Macalou B [11] (14.71%). This result can be explained by the efforts made by the supervisory authorities to provide reference structures with logistical resources: carts. The average time is 2 hours with extremes ranging from less than 1 hour to more than 2 hours. This result is comparable to that of Diarra N. [13] whose extremes are less than 1 hour and more than 4 hours. We are seeing an increase in transport time due to the unavailability of ambulances. Among the diagnoses retained after the examination in the delivery room, the main ones are: placenta previa: 20.45%; hemorrhage due to uterine atony: 13.63%; These results are different from those found by Diarra N. [13] whose main diagnoses were: stationary dilation: 15.10%; acute fetal distress 7.92%; and also those found by Thiero [9] whose diagnoses were: Vicious presentations 14.41%; Feto-pelvic disproportion14.41%; Bone dystocia 13.80%. After the diagnoses were made, we focused on one element to assess the maternal-fetal prognosis, namely the delay in the evacuations. Uterine rupture accounted for 3.41% in our study. Our frequency is higher than those of Sidibe D. [6] and Samake Y. [14] with 0.8% and 0.68% respectively. It is lower than that of Traore Y. [15] who found a frequency of 3.8%. Uterine rupture is the consequence of dystocia that is not well known or neglected. Uterine rupture is also due to the fragility of the uterus, especially in large multiparous Merger R. [8] . During our study, the frequency of eclampsia was 3.41%. Our frequency is higher than that of Hyjazi et al. [16] : 1.07% and Diarra N. et al. [13] : 1.8%. The frequency of retroplacental hematoma was 12.50% in our study.

The therapeutic approach depends on the diagnosis made and the general condition of the patient. We used: free caesarean section in 70, 45%; the low way in 29.55%; These results are different from those reported by Thiero [9] , i.e.: caesarean section in 50%; vaginal delivery in 42.50%; of those of Alamine [12] , i.e.: caesarean section in 25.30%, vaginal delivery in 73.10%.

Maternal-fetal prognosis: The general condition of some evacuees is aggravated by the delay in care and the absence of a mini blood bank. These factors increase morbidity and mortality in the short term. During the study period, we recorded 93.18% of simple postpartum compared to 6.82% of maternal mortality. Complications are mainly represented by: anemia; endometritis, eclampsia, suppuration. The fetal prognosis: It remains satisfactory with 81.82% of newborns in good condition at discharge despite the absence of a neonatology department, thanks to the efforts made by all the teams to manage cases of complications requiring urgent intervention. Manual resuscitation maneuvers make it possible in the majority of cases to correct minor respiratory distress.