Management of Obstetrical Emergencies at Aristide Le Dantec Teaching Hospital: Epidemiological Clinical and Therapeutic Aspects

Abstract

Obstetrical emergencies are a real health problem around the world. The WHO has estimated that each year more than half a million women die from obstetric complications worldwide. These obstetrical emergencies present themselves in various clinical forms and their causes are multiple and variable. They require specific and well-coded management, which helps to minimize maternal and neonatal morbidity and mortality. Objectives: To describe the epidemiological, therapeutic and evolutionary aspects of obstetrical emergencies admitted to the operating room of the maternity ward of Aristide Le Dantec Hospital. Patients and Methods: This is a descriptive cross-sectional study with retrospective data collection. It covered a period of 8 months (January 1st to August 31st, 2021) and involved 248 patients. Results: The frequency of obstetrical emergency admissions was 18.77%. The average age of the patients was 29.52 years with extremes of 15 and 44 years. Most of the pregnancies were full term (43.2%). The average gestational age was 2.16 ± 1.10 and the average delivery number was 1.16 ± 1.12. The main obstetrical emergencies recorded were: dystocia (41.53%), fetal hypoxia of all causes (41.02%), hypertensive emergencies (25.81%), hemorrhagic emergencies (15.33%) and infectious emergencies (14.92%). Caesarean section was performed in the majority of parturients (94.35%) and spinal anesthesia was the most common anesthesia technic used in 64.53% of cases. Fetal mortality was 5.13%. Maternal mortality was 1.21% and was mainly related to hemorrhagic shock. Discussion and Conclusion: Obstetrical emergencies are frequent at Aristide le Dantec Hospital. They occur in young parturients, mostly primiparous. They are responsible for a still high morbidity and mortality. The reduction of maternal and fetal mortality is a major public health objective. It could be achieved through better patient education, medicalized monitoring of high-risk pregnancies and improvement of the technical equipment.