Problem of Obstetrical Evacuations: About 630 Cases Collected at the Maternity of Bouake University Hospital

Objective: To improve the care of evacuees at the maternity of the University Hospital Center of Bouake (CHUB). Methodology: This is a cross-sectional and descriptive study over a period of three months that covered 630 cases collected at the Maternity of the university Hospital of Bouake. Results: Obstetric evacuation accounted for 42.5% of admissions to the delivery room. Patients under 20 years and over 34 years of age respectively represented 21% and 13.5% of the total. 62.7% of evacuees were not educated and 84.9% had low economic level. Nulliparous and multiparous women accounted for 54.9% of the patients and 88% had mean prenatal follow up. The evacuations were decided by midwives (91.3%), without previous adapted treatment (79.4%), with a badly filled evacuation card (49.7%) and no partograph. The taxi was the most used means of transportation (75.2%) and most evacuees took less than one hour to access the referral center (61.4%). The reasons for evacuation are mainly dominated by mechanical obstructions (34.8%); on admission the evacuees with no real reference reason were 243 (38.6%) and the diagnosis was inconsistent in 43% of cases. The majority of evacuated women delivered vaginally (69.4%). Most newborns had a satisfactory state at the 5th minute of life (79.4%) and we noted 54 cases (08.3%) of neonatal deaths. 7.8% of evacuees had a complication dominated by postpartum anemia (51.1%); we had lamented 17 cases (2.7%) of maternal deaths among evacuees, attributable to delivery haemorrhage (47.1%) and eclampsia (23.5%). Conclusion: A better organization of the reference and an equipment of the peripheral health structures would improve the prognosis of the evacuees.