Conference abstract
Management of obstetric emergencies in a tertiary hospital in Cameroon: A Milestone for End of Preventable Maternal deaths?
Pan African Medical Journal - Conference Proceedings. 2023:16(39).15
Mar 2023.
doi: 10.11604/pamj-cp.2023.16.39.2106
Archived on: 15 Mar 2023
Contact the corresponding author
Keywords: Obstetric emergencies, tertiary hospital, maternal outcome, maternal death
Oral presentation
Management of obstetric emergencies in a tertiary hospital in Cameroon: A Milestone for End of Preventable Maternal deaths?
Robert Tchounzou1,2,&, Theophile Nana Njamen2,3, Alphonse Nyong Ngalame1, Vanessa Baleba1, Inna Rakya1,4, Darolles Mwadjie Wekam1, André Gaetan Simo Wambo2,5, Humphry Neng Tatah1, Diane Estelle Kamdem1, Moustapha Bilkissou1, Félix Adolphe Elong2,6, Dominique Djomo Tamchom1, Julie Ngo Batta1, Emile Mboudou1,7
1Douala Gynaeco-Obstetric and Paediatric Hospital, Douala, Cameroon, 2Faculty of Health Sciences, University Buea, Buea, Cameroon, 3Douala General Hospital, Douala, Cameroon, 4Faculty of Medicine and Biomedical Sciences of Ngaoundéré, Garoua, Cameroon, 5Regional Hospital Limbe, Limbe, Cameroon, 6Regional Hospital Buea, Buea, Cameroon, 7Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Yaoundé, Cameroon
&Corresponding author
Introduction: maternal mortality was insufficiently reduced in Cameroon in 2015 despite the adoption of Millennium development goals. We described the patterns of obstetrical emergencies in Douala Gynaeco-obstetric and Pediatric Hospital, evaluated the outcomes of their management and the contribution to maternal mortality.
Methods: four hundred and eighteen (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 was filled for each case received during the prospective phase. Patterns of obstetric emergencies were determined and for each, the following were analyzed: 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), ad- mission in ICU, death). Factors associated with each case of death were analyzed.
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 (postpartum haemorrhage) represented 7.65% and Sickle 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, and upgrading obstetrical services with ICU will result in the least adverse maternal outcomes and especially reduced maternal mortality.
Management of obstetric emergencies in a tertiary hospital in Cameroon: A Milestone for End of Preventable Maternal deaths?
Robert Tchounzou1,2,&, Theophile Nana Njamen2,3, Alphonse Nyong Ngalame1, Vanessa Baleba1, Inna Rakya1,4, Darolles Mwadjie Wekam1, André Gaetan Simo Wambo2,5, Humphry Neng Tatah1, Diane Estelle Kamdem1, Moustapha Bilkissou1, Félix Adolphe Elong2,6, Dominique Djomo Tamchom1, Julie Ngo Batta1, Emile Mboudou1,7
1Douala Gynaeco-Obstetric and Paediatric Hospital, Douala, Cameroon, 2Faculty of Health Sciences, University Buea, Buea, Cameroon, 3Douala General Hospital, Douala, Cameroon, 4Faculty of Medicine and Biomedical Sciences of Ngaoundéré, Garoua, Cameroon, 5Regional Hospital Limbe, Limbe, Cameroon, 6Regional Hospital Buea, Buea, Cameroon, 7Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Yaoundé, Cameroon
&Corresponding author
Introduction: maternal mortality was insufficiently reduced in Cameroon in 2015 despite the adoption of Millennium development goals. We described the patterns of obstetrical emergencies in Douala Gynaeco-obstetric and Pediatric Hospital, evaluated the outcomes of their management and the contribution to maternal mortality.
Methods: four hundred and eighteen (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 was filled for each case received during the prospective phase. Patterns of obstetric emergencies were determined and for each, the following were analyzed: 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), ad- mission in ICU, death). Factors associated with each case of death were analyzed.
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 (postpartum haemorrhage) represented 7.65% and Sickle 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, and upgrading obstetrical services with ICU will result in the least adverse maternal outcomes and especially reduced maternal mortality.
