Introduction: References are frequent and most often carried out
in emergency situations. The objective of this study was to describe the
epidemiological and clinical profile of obstetric referrals to the CHU-Kara. Methodology: This was a retrospective cross-sectional descriptive study conducted from September
1, 2022, to February 28, 2023, at CHU-Kara, focusing on obstetric referrals to
the Gynecology-Obstetrics department.Result: 828 patients were referred for obstetric reasons out
of 1295 admissions, representing a frequency of 63.9%. The average age was
25.04 years. They were primigravida (38.3%), unemployed (62.7%). Motorcycles
were the main means of transportation, accounting for 53.1% of cases. The
average distance to reach the referral center was 31.6 km, covered in an
average of 71 minutes. In 40.7% of cases, patients had less than 4 prenatal
consultations and were referred in peripartum (56.6%) for pre-eclampsia (14%),
post-term pregnancy (11.8%), dystocia (10.5%). Eighty-six point nine percent
(86.9%) of the referred patients were able to deliver during their stay in the
department, of which 61.7% had vaginal deliveries. The maternal and perinatal
mortality rates were 0.7% and 14.9%, respectively.Conclusion: Obstetric referrals to Kara University Hospital are
frequent during the perpartum period and are often carried out by motorbike.
References
[1]
Prin, M., Kadyaudzu, C., Aagaard, K. and Charles, A. (2019) Obstetric Admissions and Outcomes in an Intensive Care Unit in Malawi. International Journal of Obstetric Anesthesia, 39, 99-104. https://doi.org/10.1016/j.ijoa.2019.03.004
Belinga, E., Foumane, P., Dohbit, S.J., Um, E.M.N., Kiyeck, D.K. and Mboudou, E.T. (2017) Pronostic des références obstétricales à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY). The Pan African Medical Journal, 28, Article 301. https://doi.org/10.11604/pamj.2017.28.301.10773
[5]
Goodman, D.M., Srofenyoh, E.K., Olufolabi, A.J., Kim, S.M. and Owen, M.D. (2017) The Third Delay: Understanding Waiting Time for Obstetric Referrals at a Large Regional Hospital in Ghana. BMC Pregnancy Childbirth, 17, 1-7.
https://doi.org/10.1186/s12884-017-1407-4
[6]
Aboubakari, A.S., Azoumah, D., Agbetra, N., Adamahondegla, A.B., Bassowa, A., Agbekponou, K., et al. (2009) Les aspects épidémiologiques et pronostiques des références intra-partum d’urgence au CHU-KARA. Annales de l’université de Ouagadougou, 7, 111-122.
[7]
Daniels, A.A. and Abuosi, A. (2020) Improving Emergency Obstetric Referral Systems in Low and Middle Income Countries: A Qualitative Study in a Tertiary Health Facility in Ghana. BMC Health Services Research, 20, 2-10.
https://doi.org/10.1186/s12913-020-4886-3
[8]
Banke-Thomas, A., Balogun, M., Wright, O., Ajayi, B., Abejirinde, I.O.O., et al. (2020) Reaching Health Facilities in Situations of Emergency: Qualitative Study Capturing Experiences of Pregnant Women in Africa’s Largest Megacity. Reproductive Health, 17, 2-15. https://doi.org/10.1186/s12978-020-00996-7
[9]
Atade, S.R., Obossou, A.A.A., Vodouhe, M.V., Salaou, A.A., Klipezo, R., De-Azenda, F., Koussihouede, C. and Salifou, K. (2022) Les Références Obstétricales à l’Hôpital de Zone de Banikoara: Aspects Diagnostiques, Thérapeutiques et Pronostiques. Epidemiology, Diagnosis, Management and Outcome of Obstetrical Referrals to the Banikoara Zone Hospital in 2022. Health Sciences and Disease, 24, 118-123.
[10]
Thiam, O., Cissé, M.L., Mbaye, M.M., Niang, M.M., Gueye, M., Diouf, A.A., Dièye, S. and Moreau, J.C. (2013) La problématique des parturientes évacuées en zone rurale senegalaise: exemple du centre hospitalier de Ndioum. Rev CAMES SANTE, 1, 51-56.
[11]
Ghardallou, M., Limam, M., Khelifi, A., Khairi, O., Khairi, H., Mtiraoui, A. and NabliAjmi, T. (2019) Obstetric Referrals to a Tertiary Care Maternity: A Descriptive Study. The Pan African Medical Journal, 33, Article 306.
https://doi.org/10.11604/pamj.2019.33.306.16906
[12]
Maskey, S. (2015) Obstetric Referrals to a Tertiary Teaching Hospital of Nepal. Nepal Journal of Obstetrics and Gynaecology, 10, 52-56.
https://doi.org/10.3126/njog.v10i1.13197
[13]
Akaba, G.O. and Ekele, B.A. (2018) Maternal and Fetal Outcomes of Emergency Obstetric Referrals to a Nigerian Teaching Hospital. Tropical Doctor, 48, 132-135.
https://doi.org/10.1177/0049475517735474
[14]
Jakhar, R. and Choudhary, A. (2019) Study of Maternal Outcome in Referral Obstetric Cases in a Tertiary Care Centre. Journal of Family Medicine and Primary Care, 8, 2814-2819. https://doi.org/10.4103/jfmpc.jfmpc_402_19
[15]
Prathiba, P., Niranjjan, R., Maurya, D.K. and Lakshminarayanan, S. (2020) Referral Chain of Patients with Obstetric Emergency from Primary Care to Tertiary Care: A Gap Analysis. Journal of Family Medicine and Primary Care, 9, 347-353.
https://doi.org/10.4103/jfmpc.jfmpc_836_19
[16]
Kanyesigye, H., Ngonzi, J., Mulogo, E., Fajardo, Y. and Kabakyenga, J. (2022) Health Care Workers’ Experiences, Challenges of Obstetric Referral Processes and Self-Reported Solutions in South Western Uganda: Mixed Methods Study. Risk Manag Healthc Policy, 15, 1869-1886. https://doi.org/10.2147/RMHP.S377304
[17]
Dembele, S., Diassana, M., Macalou, B., Sidibe, A., Hamidou, A., Berthe, D. et al. (2021) Les évacuations obstétricales à l’Hôpital Fousseyni Daou de Kayes. Health Sciences and Disease, 21, 90-94.
[18]
Kitilla T. (2001) Reasons for Referrals and Time Spent from Referring Sites to Arrival at Tikur Anbessa Hospital in Emergency Obstetric: A Prospective Study. The Ethiopian Journal of Health Development, 15, 17-23.
https://doi.org/10.4314/ejhd.v15i1.9892
[19]
Akaba, G.O., and Ekele, B.A. (2018) Maternal and Fetal Outcomes of Emergency Obstetric Referrals to a Nigerian Teaching Hospital. Tropical Doctor, 48, 132-135.
https://doi.org/10.1177/0049475517735474
[20]
Das, S., Patil, S., Pathak, S., Chakravarthy, S., Fernandez, A., Pantvaidya, S., and Jayaraman, A. (2023) Emergency Obstetric Referrals in Public Health Facilities: A Descriptive Study from Urban Maharashtra, India. Frontiers in Health Services, 3, 116-277. https://doi.org/10.3389/frhs.2023.1168277
[21]
Hamidou, A., Dembélé, S., Sissoko, H., Sylla, C. Camara, W. (2022) Les évacuations sanitaires obstétricales: profil épidémiologique et pronostic materno-foetal au centre de santé de référence de la commune V du district de Bamako. Revue Malienne de Science et de Technologie, 2, 17-30.
[22]
Ndiaye, N., Ndoye, O. (2016) Malaise social de la grossesse hors mariage au Sénégal. Perspectives Psy, 55, 43-49. https://doi.org/10.1051/ppsy/2016551043
[23]
Mathew, A., Cherian, A., Marcus,. T, Marconi, S., Mohan, V., and Prasad, J. (2021) What Necessitates Obstetric Transfers? Experience from a Secondary Care Hospital in India. Journal of Family Medicine and Primary Care, 10, 23-31.
https://doi.org/10.4103/jfmpc.jfmpc_2005_20
