Of the 469 recorded deliveries, we observed 172 quality deliveries, a proportion of 36.7% ( Table 1 ).

The mean age of our patients was 28.6 years, with extremes of 15 and 42 years. The most represented age group was 25 - 30 with a proportion of 33.7%, followed by 20 - 25 with 27.4% of cases. Almost all parturients (89.7%) were married women. Most of our patients had either secondary or higher education, with proportions of 35% and 34.4% respectively. Almost a third (32%) of our patients were self-employed.

Mean age: 28.6 ± 5.41 years Extremes: 15 and 42 years.

Most of our patients were pauciparous and primiparous, with frequencies of 43.80% and 36.61% respectively ( Table 2 ).

5% instrumental extraction.

See Table 3 .

Overall, the majority of patients had a favourable outcome after delivery. Only 21.5% developed complications (73.7% perineal trauma and 22.2% post-partum haemorrhage) ( Table 4 , Table 5 ).

5% instrumental extraction. P-Value = 0.0001; RR = 0.085 [0.045 - 0.159].

HRP GIIIB of Sher: Retroplacental hematoma Grade IIIB of Sher.

No maternal deaths were recorded during the study period, although 2.4% of patients were referred to a level 1 hospital for obstetric complications ( Table 6 ).

See Table 6 .

NB: we recorded 2.1% twin pregnancies.

7.4% of newborns were referred to a neonatology department for neonatal complications. The main reasons for referral were acute fetal distress and prematurity ( Table 7 ).

See Table 8 .

P-Value = 0.086; RR = 0.379 [0.096 - 1.49].

The vast majority of newborns (98%) were born alive. However, we recorded 2% perinatal deaths. Of these, 66.8% were born vaginally. However, we did not find a specific risk of exposure related to the route of delivery (P = 0.086, RR= [0.096 - 1.49]).

The results showed that the main cause of perinatal death was acute fetal distress, accounting for 66.6% of all causes of death. Other causes of death included retroplacental hematoma and uterine rupture. One of the newborn deaths was a polymalform with hydrocephalus, spina bifida and polydactyly ( Table 9 ).

The proportion of quality deliveries during the study was 36.8%. This low proportion could be explained by a number of factors including, among others, low service capacity in relation to activities, shortcomings in the provision of care services, lack of hygiene. In Guinea, HATEM.M et al., in 2018 reported 33% quality deliveries at I Deen National Hospital [7] resulting in a high maternal mortality rate of 679/100,000 NV.

• Age: the mean age of our patients was 28.6 years, with extremes of 15 and 42 years. However, the most represented age group was 25 - 30 years with a proportion of 33.7% followed by 20 - 25 years with 27.4% of cases. In a study carried out in Guadeloupe in 2013, Butoria J B. et al. reported an average age of 30 with extremes of 18 and 44 years [9] . This average age could be explained by the fact that it corresponds to a period of full genital activity whatever the country.

• Marital status: Almost all parturients (89.7%) were married women. This proportion is higher than that of Doucin H et al., who reported that 54% of parturients in their sample were married women [10] . This could be explained by the socio-cultural and religious requirements of our context, which make it difficult to conceive outside of marriage, and where marriage is the legal framework for procreation.

• Educational level: most of our patients had either secondary or higher education, with proportions of 35% and 34.4% respectively. A WHO global survey showed that fertility was inversely proportional to women’s level of education. Women with no education have on average 2 times more children than those with 7 or more years of schooling [3] .

• Profession: We found that 32% of our patients were self-employed, while pupils and students represented 29.4%. This could be explained by the fact that more and more women are seeking to find an income-generating activity that would make them less dependent on their spouse or family.

• Parity: most of our patients were pauciparous and primiparous, with frequencies of 43.8% and 36.6% respectively. Our result is identical to that of Diémé F. M.E, et al. in Senegal in 2015 who reported that pauciparous were in the majority with 73.7% of cases with an average parity of three [11] . Efforts must be made by health workers to minimize the risks incurred by these women. This high proportion of pauci pares could be explained by the young age of the patients and the early marriages under our conditions.

• Mode of delivery: Most of our parturients (59.9%) gave birth by Caesarean section. This proportion of Caesarean sections is above the national average and is justified by the fact that our service is a referral service for the basic health structures of the commune and those of certain communes in the capital. Coulm B in France in 2013 reported, that only 10.9% of parturients had given birth by caesarean section including 31.7% primiparous and 68.3% multiparous [12] .

• Mode of delivery and maternal morbidity: results showed that after delivery, most patients did not develop complications, and were discharged with a good maternal prognosis. However, 21.5% had developed complications. The difference was statistically significant (P-Value = 0.0001), although the route of delivery did not appear to increase the risk of complications (P = 0.0001; RR-IC = 0.085 [0.045 - 0.159]).

• Type of maternal morbidity: Perineal trauma and postpartum hemorrhage were the most common complications observed after delivery, accounting for 73.74% and 22.2% of all complications respectively. Our complication frequency of 21.5% is lower than the 41.5% of complications reported by, Foumsou L. et al. in Chad in 2017 with a predominance of haemorrhage at delivery with 20.7% of cases followed by cervical tear with 9.4% of cases [13] .

• Maternal mortality: No maternal deaths were recorded during the study.

• Neonatal morbidity: 7.4% of newborns had been referred to a neonatology department for neonatal complications. The main reasons for referral were acute fetal distress (68.6%) and prematurity (17.1%). In addition, 8% of newborns were of low birth weight and 8.5% were macrosomic. The proportion of twin pregnancies was 2.1%.

• Neonatal mortality: The vast majority of newborns (98%) were born alive. However, we recorded 2% perinatal deaths. Of these, 66.8% were born vaginally. However, we did not find a specific risk of exposure linked to the route of delivery (P = 0.086, RR = 0.379 [0.096 - 1.49]). In a study carried out in several West and Central African countries, Pruel. A et al. report neonatal mortality rates that vary widely from one country to another. Thus we note, 12‰ NV (ODD already reached) in Cape Verde, 21‰ nv in Senegal and 34‰ NV in Nigeria [5] . The influence of this quality of care can be seen by comparing the perinatal mortality rate in developed countries, which is <10/1000 NV versus 27‰ nv in Lumumbassi, and 87‰ in Kinsassa in 2019 [14] .

• Causes of neonatal death:

The results showed that the main cause of perinatal death was acute fetal distress, accounting for 66.6% of all causes of neonatal death. The other deaths had various causes: retroplacental hematoma, uterine rupture. One of the newborns who died was poly malformed with hydrocephalus, spina bifida and polydactyly. Foumsou L et al. in Chad in 2017 reported that the neonatal complications listed were neonatal death 4.3%, respiratory distress 2.3% and prematurity 1.9% [13] .