Publication:

Problem of obstetrical evacuations of patients coming from maternities outside the coverage zone of the university and hospital center of Treichville (Abidjan-Côte d’Ivoire)

Background In developing countries, the organization of obstetrical evacuations is experiencing real problems causing certain preventable maternal and fetal morbidity and mortality. Objective of present study was to describe the sociodemographic characteristics and conditions of transfer of patients from peripheral maternities not dependent on the health coverage zone of the University and Hospital Center of Treichville (called maternity out of zone).

Methods This is a prospective and descriptive study, conducted at the maternity of the University and Hospital Center of Treichville, from 1st August 2012 to 31st July 2014 about 266 patients evacuated from maternity out of zone.

Results Only 30% of the patients had properly documented evacuation records. Patients had an average age of 26.9 years, poor follow-up of their pregnancy (92.1%), and were generally low socio-economic level: without monthly income (61.7%), not attending school (35.3%). The majority of evacuations were decided by midwives (60.9%) and were done by taxi (69.5%). In 71.4% of the cases, the patients were re-evacuated to our department with the main reason for the unavailability of the operating rooms (84.3%). 46.6% of the patients took more than 3 hours to arrive in our department and 35% arrived in an aggravated condition and sometimes without venous routes. In our department, complications occurred in 27.1% of the patients, and maternal and fetal death rates were respectively 1.5% and 21.3%.

Conclusions This study revealed malfunctions encountered during evacuations: unsafe transportation, transfer card misinformed, long transfer time.