TITLE:
Sanitary Evacuations at the Maternity Unit of the Social Hygiene Institute (IHS) in Dakar in 2020
AUTHORS:
Mouhamadou Mansour Niang, Mohamaed Amine Inzale, Fatou Samb, Cheikh Tidiane Cisse
KEYWORDS:
Obstetrical Evacuations, Institute of Social Hygiene, Maternal-Fetal Prognosis
JOURNAL NAME:
Advances in Reproductive Sciences,
Vol.11 No.4,
November
23,
2023
ABSTRACT: Objective: Determine the frequency of evacuations, specify
the epidemiological and clinical characteristics of the evacuees, evaluate the data
of the evacuation, the management and the maternal-fetal prognosis. Methods: Prospective and descriptive retrospective study
concerning obstetrical evacuations received at the maternity ward of the
Hospital of the Institute of Social Hygiene in Dakar between January 1 and
December 31, 2020, i.e. a period of
12 months. Results: During the study period, we collected 1156 evacuees out of a total of
3507 patients treated in the Service, i.e. a frequency of 33%. The average age of the patients was 27.07 years with
extremes of 14 and 46 years. Patients aged between 20 and 29 were the most
represented (51.73%). The average parity was 1.6 with extremes of 0 and 10
pares. The nulliparous (46.37%) were the majority. The majority of evacuated
patients (99.6%) resided in the Dakar region, including 58% in the suburbs and
42% in the city center. The patients received had performed an average of 3
prenatal consultations with extremes ranging from 0 to 9 CPN. They most often
came from health centers (55.05%) or hospitals (29.09%). The reasons for
evacuations were dominated by dystocia (21.54%) followed by premature rupture
of membranes (17.21%) and premature deliveries (16.35%). On admission, only 176
patients (15.2%) had an evacuation sheet. Patients transited on average through
two health structures (extremes ranging from 0 to 7 structures) before reaching
the reception structure. The evacuation was most often done with a private
vehicle on the patient’s own means (91.96%). The outcome of the evacuees was
most often vaginal delivery or hospitalization (72.79%). The majority of
patients (99.4%) had evolved favorably but we deplore one maternal death
(0.09%) linked to a late puerperal infection. We recorded 74 perinatal deaths
and 1041 live births, i.e. a
stillbirth rate of 71.1‰ live births. The causes of death were dominated by
prematurity (24.7%). Conclusion: Obstetrical evacuations are frequent in
our practice but they should be better organized to improve the maternal-fetal
prognosis.