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EMERGENCY OBSTETRIC REFERRALS AT A UNIVERSITY TEACHING HOSPITAL, NIGERIA
Abstract
Objective: To identify factors in our unbor~ked obstetric emergency cases that contribute to
the increase in maternal mortality.
Design: A retrospective study.
Setting: Maternity Ward. C!niversity of Nigcria Teaching Hospital, Enugu, Nigeria, between
January 1966 atid Dece~nher 1999.
Subjects: Four hundred and thirty five cases of emergency obstetric referrals treated during
the revicw period.
Results: The incidence of unbookcd obstetric emtrgencics is 9.5 % and the high risk obstetric
group, the prirnigra\ ida and grand multipdrour women constituted 63% of it. Majority
(80%) of the patients hclonged to the lower so&-economic class and prolonged and
obstructed lahour nerc the cnmnlonest mode of presentation. Source5 of referrals were
hospital/clinics (46 I, maternity homes (23 5,). traditional birth attendants (TBAs)(l6% j
and prayer house5 r 2.3 % j. There wrre obvious delays at the referral sources and most of the
patients presented in pour clinical states. Forty per cent of total maternal mortalily in the
hospital were attributed tu unbookcd cases with haemorrhaye and sepsis being the major
causes. Also pcrinatal rnortalitj uf 40.2% was recorded.
Conclusions: Lack of ha& cducation and poverty are the major identifiable risk factors.
Improving health carc fhcilitier;. female education, regular training counes for m~dical
personnel and tIimination of quacks are advocated.
the increase in maternal mortality.
Design: A retrospective study.
Setting: Maternity Ward. C!niversity of Nigcria Teaching Hospital, Enugu, Nigeria, between
January 1966 atid Dece~nher 1999.
Subjects: Four hundred and thirty five cases of emergency obstetric referrals treated during
the revicw period.
Results: The incidence of unbookcd obstetric emtrgencics is 9.5 % and the high risk obstetric
group, the prirnigra\ ida and grand multipdrour women constituted 63% of it. Majority
(80%) of the patients hclonged to the lower so&-economic class and prolonged and
obstructed lahour nerc the cnmnlonest mode of presentation. Source5 of referrals were
hospital/clinics (46 I, maternity homes (23 5,). traditional birth attendants (TBAs)(l6% j
and prayer house5 r 2.3 % j. There wrre obvious delays at the referral sources and most of the
patients presented in pour clinical states. Forty per cent of total maternal mortalily in the
hospital were attributed tu unbookcd cases with haemorrhaye and sepsis being the major
causes. Also pcrinatal rnortalitj uf 40.2% was recorded.
Conclusions: Lack of ha& cducation and poverty are the major identifiable risk factors.
Improving health carc fhcilitier;. female education, regular training counes for m~dical
personnel and tIimination of quacks are advocated.
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