Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergencies, to describe the care taking of emergencies and to establish the maternal foetal prognosis of obstetric emergencies. Methodology: It was a 6-month descriptive prospective study conducted in the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU Conakry , Guinea. The study took place from July 1st to December 31st, 2005. The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data. The limitations of the study: The poor filling of the partograph has been the main problem of our study. Results: The frequency of obstetric emergencies was 19% in the Department. The socio-demographic profile was that of a woman aged 15 to 24 (46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous (34.3%), without prenatal follow-up (47.37%), coming from home (56%), evacuated (44%). The main emergencies are dominated by haemorrhage (34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%). The therapeutic attitude was based on clinical data and was dominated by caesarean section (70%). General anaesthesia was performed in 75% of cases and 1.6% benefited from local anaesthesia . The demand for blood was honoured in 19% of the cases . The maternal morbidity was dominated by anaemia (66.7%) and a lethality of 4% . After the 5th minute , 47% of the newborns had APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion: To avoid and/or reduce obstetric emergencies, it is necessary to detect and treat risk factors during referrals, properly monitor child labor, refurbish providers of basic facilities, promptness in the management of the admission of emergencies and the availability of blood products.
Obstetric emergencies are accidents that occur suddenly during pregnancy and in the aftermath of diapers exposing women to serious risks and whose evolution is sometimes fatal [
The most common complications are: haemorrhage, dystocia, SFA (sharp fetal suffering), eclampsia and pre-eclampsia.
However, safe motherhood remains the major challenge for any action to improve maternal and child health [
Obstetric emergencies are common in developing countries.
In Benin in 2013, at the University Hospital of Parakou, obstetric emergencies accounted for 31.8% with a maternal lethality of 0.4% and a foetal rate of 9.2% [
In Mali in 2007, 12.24% of obstetric emergencies are at the reference health centre of the commune IV with a maternal lethality of 1% and foetal mortality of 23.9% [
In Guinea, at the Labe Regional Hospital in 2013, obstetric emergencies represented 14.75% with a maternal lethality of 2.5% and foetal malnutrition of 3% [
Thus, we conducted this study with the objectives of calculating the frequency of obstetric emergencies, describing the socio-demographic profile of women admitted for obstetric emergencies, identifying the main emergencies, describing the management of emergencies and establishing the maternal-foetal prognosis of obstetric emergencies.
It was a 6-month descriptive prospective study conducted at the maternity of the DONKA National Hospital, which is a 3rd level referral facility in Guinea.
The study focused on a continuous series of 633 obstetric emergencies. All patients admitted for an obstetric emergency in the Department were included in the study. Patients who died on admission, patients with no obstetric emergencies and those who did not consent to the study were excluded from the study.
The study took place from July 1st to December 31st, 2005.
The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data.
The limitations of the study: The poor filling of the partograph has been the main problem of our study.
The variables studied were: epidemiological, clinical, para-clinical, therapeutic and prognostic.
During our study period we recorded 633 obstetric emergencies for a total of 3396 admissions, equivalent to a frequency of 19%.
1) Age. The age group of 15 to 24 is the most concerned (45.8%) (n = 290) with an average age of 25.38 years and extremes of 14 and 44 years.
2) Profession: Housewives were the most met (38.1%).
3) Level of education: The majority of our patients were illiterate 49.5%.
4) Matrimonial status: Married women accounted for 91.6% of patients.
1) Admission Mode: 353 patients came directly from their home (56%) and 280 were evacuated or referred by the other health structures (44%).
2) Evacuation reasons:
Evacuated patients were admitted without evacuation papers (49.64%), while 21.42% of patients were discharged for HTA and eclampsia and 7.5% for HRP.
3) Reasons for consultation: The main emergencies are dominated by bleeding (34.5%) followed by hypertension and eclampsia (28.6%).
4) Parity: Nulliparous women represented 34.3% of our patients followed by pauciparas 26.1%.
5) Prenatal follow-up: Patients without prenatal care accounted for 47.37%.
The therapeutic attitude was based on clinical data. Caesarean section was performed immediately in 70.6% of cases, vaginal delivery in 10% and laparotomy in 4% of our patients. 19% of our patients benefited from a blood transfusion. General anesthesia was performed in 75% of our obstetric emergencies and 1.6% benefited from local anesthesia.
1) Morbidity: 6% of our patients developed complications during the delivery.
2) Types of maternal complications: These complications are dominated by anemia (66.7%) followed by infections (33.3%).
3) Maternal lethality: We recorded 24 cases of maternal deaths, a frequency of 4% of our obstetric emergencies.
4) Causes of maternal deaths: The main causes of these deaths were hemorrhage 37.5%, followed by eclampsia 20.8%.
1) APGAR Score: 60% of newborns had APGARs between 7 - 9 in the 1st minute, while in the 5th minute 47% had APGARs between 7 - 9 and only 2% had APGARs between 4 to 6.
2) Neonatal mortality: 120 cases of fetal death (115 cases of dying born and 5 cases of fetal deaths) were recorded out of a total of 571 births, i.e. a frequency of 21%.
56.7% of our obstetric emergencies took between 1 to 4 days of hospitalization while 0.6% performed between 21 to 24 days of hospitalization.
We collected 633 cases of obstetric emergencies out of a total of 3396 admissions, i.e. a frequency of 19%. This result is included the one found by CISSE SA [
1) Age: The age group 15 to 24 is the most concerned (45.8%) (N = 290) with an average age of 25.38 years and extremes of 14 and 44 years. 0.15% of our patients were under 15 years old. This young age could be explained by the psychological immaturity of young age patients and/or early marriage. GUINDO SB [
2) Profession: Housewives were the most met (38.1%), similar to TOURE.I [
3) Level of education: The majority of our patients were illiterate 49.5%. This rate of women who did not go to school is in line with that of the general population in Guinea, where 74% of illiterates are women, 85.3% of whom are women, according to the Guinean DHS4 [
4) Matrimonial status: Married people accounted for 91.6% of patients. This result is superimposed on that found by TOURE.I [
1) Mode of admission: 353 patients came directly from their houses (56%) and 280 were evacuated or referred to other health facilities (44%) This result is similar to that of BLAISE A.T. et al., in Benin [
2) Evacuation reasons:
Evacuees were admitted without evacuation papers (49.64%), while 21.42% of patients were discharged for HTA and eclampsia and 7.5% for HRP. In his study, CISSE S.A [
3) Reasons for consultation: The main emergencies are dominated by haemorrhage (34.5%) followed by hypertension and eclampsia (28.6%). This rate of haemorrhage is lower than that found by TOURE I. [
4) Parity: Nulliparous women represented 34.3% of our patients followed by pauciparas 26.1%. This result is superior to that found by TOURE I. [
5) Prenatal follow-up: Patients without prenatal care accounted for 47.37%. This result is similar to that found by CISSE SA [
The therapeutic attitude was based on clinical data. Caesarean section was performed immediately in 70.6% of cases, vaginal delivery in 10% and laparotomy in 4% of patients. 19% of our patients received a blood transfusion. General anesthesia was performed in 75% of our obstetric emergencies and 1.6% benefited from local anesthesia. Our cesarean section rate is intermediate like that found by CISSE SA [
1) Morbidity: 6% of our patients developed complications during the delivery.
2) Types of maternal complications: These complications are dominated by anemia (66.7%) followed by infections (33.3%) Our anemia rate is intermediate between that found by CISSE B. [
3) Maternal lethality: We recorded 24 cases of maternal deaths, a frequency of 4% of our obstetric emergencies. This result is similar to that of GUINDO S.B [
4) Causes of maternal deaths: The main causes of these deaths were hemorrhage 37.5%, followed by eclampsia 20.8%. The finding is similar in the studies of Dellagi RT [
1) APGAR Score: 60% of newborns had APGARs between 7 - 9 in the 1st minute, while in the 5th minute 47% had APGARs between 7 - 9 and only 2% had APGARs between 4 to 6.
2) Neonatal Mortality: We recorded 120 cases of fetal deaths (115 cases of dead born and 5 cases of fetal deaths) out of a total of 571 births, a frequency of 21%. These deaths could be explained by the delay in referral or evacuation. Some unforeseeable complications (HRP, PP, UK, SFA) and delay in promptness of emergency care.
56.7% of our obstetric emergencies took place between 1 to 4 days of hospitalization while 0.6% performed between 21 to 24 days of hospitalization. CISSE SA [
To avoid and/or reduce obstetric emergencies, it is necessary to identify and treat risk factors during referrals, properly monitor childbirth, refurbish providers of basic facilities, readiness for the care taking of the emergencies and the availability of blood products.
The authors declare no conflicts of interest regarding the publication of this paper.
Diallo, B.S., Balde, I.S., Conte, I., Diallo, M.H., Balde, O., Sylla, I., Diallo, A., Bah, O.H., Sow, F.B., Sy, T., Hyjazi, Y. and Keita, N. (2019) Care Taking of Obstetric Emergencies in the Department of Gynaecology and Obstetrics at Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea. Open Journal of Obstetrics and Gynecology, 9, 604-611. https://doi.org/10.4236/ojog.2019.95059