Intra-Hospital Delay in Emergency Care at the Obstetrics and Gynecology Department in the University Teaching Hospital of Ouagadougou (UTH-YO), Burkina Faso

Ouedraogo Issa,Bonane Blandine,Ouédraogo Ali,Traoré Françoise Danielle,Yaméogo Relwendé Barnabé,Tougma Aline Pegwendé,Ouattara Adama,Kiemtoré Sibraogo

doi:10.4236/ojog.2017.712116

Abstract

Objective: To investigate the intra-hospital delay in the treatment of gynecological and obstetric emergencies in the obstetrics and gynecology department at the UTH-YO. Patients and methods: It has been a prospective and descriptive study over a period of four months from 1 May to 31 August 2015 in the obstetrics and gynecology department at the UTH-YO. All patients and their escorts were included in our study, admitted to gynecological or obstetric emergencies who have accepted to participate in the survey. Data were entered and analyzed using a PC equipped with the SPSS 16.0 software English version. Results: During the study period, we recorded 2627 admissions. Delays in the management involved 216 patients or a frequency of 8.2%. The average age of patients was 26.6 ± 6.2 years, ranging from 16 and 46 years. Patients had no income in 165 cases (that is to say 76.4%). The referred patients accounted for 165 admissions (85.7%). The intake patterns were dominated by obstetric acute fetal distress in 44 cases (20.4%), pre-failure syndrome in 27 cases (that is to say 12.8%) and in gynecology by the ectopic pregnancy in 171 cases (79.3%). The average waiting period between the arrival of a patient and the beginning of first aid was 2 hours and 23 minutes with extremes of 16 min and 546 min. The main reason for the delay was the unavailability of the operating room in 61.1% of cases. The opinion of escorts was dominated by improving communication with the creation of a post of information in 47% of cases. Maternal prognosis was marked by a maternal death in 0.1% of cases and maternal morbidity in 13.4% of cases. The fetal prognosis was dominated by death at birth in 13.8% of newborns. Conclusion: Despite the subsidy of the government in obstetric and neonatal emergencies, there remain intra-hospital delays in the management of emergencies. The opening of discussions between the various stakeholders responsible for the implementation of this grant is urgent to contribute more effectively to the fight against maternal mortality.

Highlights

According to the World Health Organization (WHO), the African continent recorded the highest maternal mortality ratios in the world [1]
Patients and methods: It has been a prospective and descriptive study over a period of four months from 1 May to 31 August 2015 in the obstetrics and gynecology department at the UTH-YO. All patients and their escorts were included in our study, admitted to gynecological or obstetric emergencies who have accepted to participate in the survey
In total 81% of the patients were from the city of Ouagadougou and 19% of surrounding communities

Summary

Introduction

According to the World Health Organization (WHO), the African continent recorded the highest maternal mortality ratios in the world [1]. Since the call of Nairobi in 1987 for maternal health, epidemiology of maternal mortality is fairly well known. Since 2006, the Government of Burkina Faso has awarded a grant to obstetric and neonatal emergencies care (EmOC). The subsidy for the transportation of patients, hospital costs and emergency medicines was supposed to lessen the different delays in the care to pregnant women and newborns [6]. A few years after the implementation of this new strategy, we intend to evaluate the intra-hospital delay in the management of patients within the first National and University referral hospital in Burkina Faso

Methods

Results

Conclusion