Sante (Montrouge, France) · 2007
[Audit of the severe obstetrical morbidity (near miss) in Gabon].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Mayi-Tsonga Sosthène, Meyé Jean-François, Tagne Alain, Ndombi Isabelle, Diallo Thierno, Oksana Litovchenko, Mendome Gabriel, Mounanga Mathieu
Аннотация
OBJECTIVE: To examine "near-miss" cases to identify the weak points of our department.
MATERIAL AND METHODS: This prospective study took place at the Libreville Hospital Maternity Center for six months, from 1 June to 31 December 2006. It included all pregnant women with a severe obstetrical complication (uterine haemorrhage with signs of shock, eclampsia, severe infection) or whose condition required a major intervention to prevent death. The quality of these patients' management was studied from their arrival in the department to their discharge.
RESULTS: The prevalence of near-misses was of 3.15%, that is, 137 cases among 4350 deliveries. Ruptured ectopic pregnancies, haemorrhage following clandestine elective abortions, and post-partum haemorrhages (third stage of delivery) were the three primary causes for near misses. Almost 40% of these women waited more than 45 minutes before seeing any qualified personnel. Once the patient was seen, clinical examinations were impossible for 22% because of the lack of the appropriate material. The average time to surgery was 5 hours and 15 minutes. The lack of sterilized surgical linens was one of the major causes of delay in surgical management.
CONCLUSION: The number of patients seeking care in our department, relative to the staff resources, makes it difficult to optimise the quality of emergency obstetric care.
MATERIAL AND METHODS: This prospective study took place at the Libreville Hospital Maternity Center for six months, from 1 June to 31 December 2006. It included all pregnant women with a severe obstetrical complication (uterine haemorrhage with signs of shock, eclampsia, severe infection) or whose condition required a major intervention to prevent death. The quality of these patients' management was studied from their arrival in the department to their discharge.
RESULTS: The prevalence of near-misses was of 3.15%, that is, 137 cases among 4350 deliveries. Ruptured ectopic pregnancies, haemorrhage following clandestine elective abortions, and post-partum haemorrhages (third stage of delivery) were the three primary causes for near misses. Almost 40% of these women waited more than 45 minutes before seeing any qualified personnel. Once the patient was seen, clinical examinations were impossible for 22% because of the lack of the appropriate material. The average time to surgery was 5 hours and 15 minutes. The lack of sterilized surgical linens was one of the major causes of delay in surgical management.
CONCLUSION: The number of patients seeking care in our department, relative to the staff resources, makes it difficult to optimise the quality of emergency obstetric care.