Obstetric emergencies in a humanitarian context at the Somine Dolo hospital in Mopti, Mali

Background: Conflicts are a barrier to physical and financial access to health centers. Our objective was to evaluate obstetric emergencies in a humanitarian context at the Sominé DOLO hospital in Mopti.Methods: This was a descriptive and prospective longitudinal study from January to September, 2020 in the obstetrical gynecology department of the Sominé DOLO hospital in Mopti. Our objective was to evaluate obstetric emergencies in the humanitarian context.Results: The frequency of patients evacuated was 30.61%. The average age of the patients was 27 years with extremes of 15 and 49 years. Hemorrhage during pregnancy was the main cause of reference with 23.83%. The ambulance was the most used means of transport with 51%. Delay in evacuation was observed in 31.33 cases. About 73.03% of our patients had given birth by caesarean section. We recorded 64 maternal deaths, a rate of 10.67%. Fetal mortality in our study was 23.28%. Attacks by armed groups had a negative impact on the referral/evacuation system.Conclusions: The health system had experienced severe challenges due to insecurity. Armed conflicts were the cause of evacuation delays. Haemorrhage during pregnancy was the main reference cause. Maternal and perinatal mortality was high

Conclusions of ten years of maternal death surveillance and response in the health district of commune V of Bamako, Mali

Background: The purpose of this study was to report the findings of the local maternal deaths surveillance and response (MDSR) committee in the health district of Municipality V of the district of Bamako. Methods: It was a retrospective study over a period from January 2009 to December 2017. We have compiled all the findings of the local MDSR committee from the health district of Municipality V. The data was generated from the Local Health Information System (LHIS). We made a simple entry of text and tables using Word and Excel software. Results: During the study period, the maternal mortality ratio (MMR) was 219/100,000 live births. The study was about 140 cases of maternal deaths that occurred in health facilities. The middle age of the patients was 28.01 years. Most of the deaths occurred in the postpartum period, with 106 cases. In 92.12%, the deaths were from direct obstetric causes (DOC), including hemorrhage 70%, eclampsia 7.85%, obstructed labor 7.14%. Seven deaths (5%) were from indirect obstetric causes (IOC), including anemia 3.57% and malaria 1.73%. In 2.58%, the deaths were from undetermined causes. Deaths were preventable in 80%. The response included, among other things, the notification of cases and the implementation of the recommendations made. In 70% of cases, the recommendations issued were implemented. Conclusions:  The MMR remains high in Municipality V of the district of Bamako. These deaths were mostly from DOCs, with hemorrhage as the main cause. These deaths were mostly preventable.