The Prognosis of Obstetric Evacuation in Rural Areas in Senegal, Example of Ourossogui Rural Hospital

Abstract

Objectives: To describe the epidemiological and clinical profile of the evacuated patients, to analyze the means of evacuation as well as the cost of the evacuation, and finally, to evaluate the maternal-fetal prognosis of the evacuated patients.Material and methods: We carried out a prospective study going from January to December 2015 covering all obstetric emergencies evacuated at the Ourossogui maternity ward. Study variables: epidemiological; evacuation conditions, diagnostic and therapeutic aspects and prognostic aspects.Results: The frequency of obstetric evacuation was 66.2%. Our patients were primiparous (39.2%), out of school (85.6%), married (97.7%) and low income (94.7%) with an average age of 24.8 years. The average number of CPNs was 2.6. More than one in three women had 4 CPNs or more (33.6%). The distance traveled averaged 45.6 km with extremes of 1 km to 160 km. The ambulance was used in 90% of cases. The reasons for evacuation were dominated by obstructed labor in 29.4%; hemorrhages in 26.5%. Eight home deliveries and four en route were noted. The maternal prognosis was favorable in 98.6%. Seventeen cases of death were recorded, ie 1.4%. The child was alive and well in 83.2% and deaths accounted for 16%. Maternal deaths most often occurred among illiterate, low-income, multi-gesting women with fewer than 4CPNs under 35 years of age who traveled long distances and were evacuated by unskilled staff.Conclusion: Emergency obstetric evacuation represents a major challenge for the health system in the Matam region. Improvements include literacy training for the population, continuous training of health personnel and recruitment of practitioners.