Mouhamadou Mansour Niang, SO Ntap, F Samb and CT Cisse
Objectives: Describe the epidemiological profile of patients, specify the characteristics of the delivery and evaluate the maternal and perinatal prognosis at the Maternity Hospital Institute of Social Hygiene in Dakar.
Materials and Methods: This was a retrospective and descriptive study conducted over a period of six months from January 1 to June 30, 2019, involving all women who gave birth in the Gynecology-Obstetrics Department of the Institut d'Hygiène Sociale Hospital in Dakar.
Results: During the study period, we collected 689 delivery records, i.e., 8.2% of the department's overall activities and 69% of emergency activities. The epidemiological profile of the patients was that of a woman with an average age of 27 years, married (96%), with an average parity of 2, and residing outside the Southern Health District of Dakar (58%). More than half of the patients (58.1%) had received at least 4 prenatal consultations. The majority of parturients had a single pregnancy (97%) at term (72%). Uterine height measurement and fetal heart rate assessment were normal in 59% and 95.5% of the sample respectively. The vaginal touch revealed ruptured membranes in 34.5% of the patients with amniotic fluid that was mostly clear (68.1%) and a vertex presentation (96%). Clinical pelvimetry allowed the diagnosis of 19% of moderately narrowed pelvises and 2% of surgical pelvises. Slightly more than half of the parturients (56.6%) were in the latent phase of labor. We recorded 130 labor events (18.9%), 67 uterine events (9.7%), 76 directions of labor (11%), and 45 labor inductions (6.5%). In our series, 55.4% of the patients had benefited from labor monitoring by cardiotocograph and complications were found in 25.5% of the patients. These were mainly cases of non-reassuring fetal status (71.8%). More than half of the parturients (55.3%) had given birth by vaginal delivery. Caesarean sections and instrumental extractions represented 44.6% and 0.1% of deliveries respectively. Complications recorded (6.8%) were dominated by retroplacental hematoma (4%) and eclampsia (1.1%). We recorded 98% live births. Most newborns (87.4%) had an Apgar score of 7 or more at the first minute. We recorded 82% eutrophic, 13.3% hypotrophic, and 4.7% macrosomic newborns. Among the newborns transferred to neonatology (9.8%), 17.4% died during hospitalization. Stillbirth was estimated at 20‰ live births.
Conclusion: Childbirth constitutes the main emergency activity at the Maternity Hospital of the Institute of Social Hygiene of Dakar with low maternal and perinatal morbidity and mortality.
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