TITLE:
Management of Obstetric Emergencies in a Tertiary Hospital in Cameroon: A Milestone for End of Preventable Maternal Deaths
AUTHORS:
Robert Tchounzou, Theophile Nana Njamen, Alphonse Nyong Ngalame, Vanessa Baleba, Inna Rakya, Darolles Mwadjie Wekam, André Gaetan Simo Wambo, Humphry Neng Tatah, Diane Estelle Kamdem, Moustapha Bilkissou, Félix Adolphe Elong, Dominique Djomo Tamchom, Julie Ngo Batta, Emile T. Mboudou
KEYWORDS:
Obstetric Emergencies, Tertiary Hospital, Maternal Outcome, Maternal Death
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.12,
December
30,
2020
ABSTRACT: Background: Maternal mortality was insufficiently reduced in
Cameroon in 2015 despite the adoption of Millennium development goals. To tackle
the situation and meet the sustainable Millennium goals target of 140/100,000
live births by 2030, the Government adopted the strategies of building
reference hospitals where high quality obstetric care, timely and optimal
management of obstetric emergencies will be offered. The
objective of this study was to
describe the patterns of obstetric emergencies in Douala Gynaeco-obstetric and Paediatric Hospital, evaluate the outcomes of their management and the
contribution to maternal mortality. Patients
and Methods: 418 patients with obstetric emergencies were
included in a two-phase
cross-sectional
study. Data were retrieved from patients’ case notes during the retrospective
phase and a questionnaire filled for each case received during the prospective phase.
Patterns of obstetric emergencies were determined and for each, the following
were analysed: patient managed in this hospital or referred from other hospitals, management according to
hospital guidelines, timing of care, result of management (recovery with no
admission in ICU (intensive care unit),
admission in ICU, death). Factors associated with each case of death were
analysed. Results: The patterns of obstetric emergencies (OE) were dominated by HDP (hypertensive
diseases in pregnancy) (20.57%), abortions (14.83%), Ectopic
pregnancies (13.87%), Acute foetal distress (13.15%) and Obstructed labour
(9.56%). PPH (post partum haemorrhage) represented
7.65% and Sikcle cell crisis (SCA) 0.91%. 40% of cases were referred from other
hospitals. Six cases of deaths were recorded with a global case fatality of
1.43%. The causes of death were PPH, HDP, and Sickle cell anaemia 33.33% each.
The case fatality of SCA was 50%, disclosing our worst performance. Conclusion: Management
of OE following standardized hospital guidelines, reinforcement of referral
systems, upgrading obstetrical services with ICU will result in least adverse
maternal outcomes and especially reduced maternal mortality.