Impact of day of delivery on obstetric and perinatal outcome: a 10 years retrospective descriptive and analytical study at the Phillipe Maguilen Senghor Health Centre, Dakar, Senegal

Background: For a lot of women, childbirth is still a feared moment. Despite considerable progress in the management of childbirth and its complications, maternal and neonatal morbidity and mortality are still a major problem even in developed countries. To evaluate the influence of day of delivery on obstetrical and perinatal outcome.Methods: Retrospective cohort study conducted at the Philippe Maguilen SENGHOR health center maternity ward from January 1, 2011 to June 30, 2019, on patients with a pregnancy of more than 22 weeks of amenorrhea who were received for delivery management. The deliveries periods were divided according to whether they occurred on a working day (deliveries from Monday to Friday, excluding public holidays) or on weekends and public holidays (deliveries on Saturdays, Sundays and days declared as public holidays according to the Gregorian and Senegalese event calendars). The data were extracted from our E-perinatal database and analysed in the Statistical Package for Social Science (SPSS 24, Mac version).Results: Over 102 months, we recorded 42 870 deliveries. The average age of the patients was 27 years with extremes of 13 and 50 years. Nearly one in three deliveries took place on a holiday or weekend (n=13566-31.6%). The rate of caesarean delivery on weekends/holidays (18.8%) was lower than that on weekdays (21%). The odds ratio of having/benefiting from a weekend/holiday caesarean section was 0.87 (CI 0.83-0.92, p<0.0001). Our results suggest that patients who deliver on weekdays are more likely to receive a caesarean section than those who deliver on weekends or holidays. Perineal injury, World Health Organization obstetric complications, and neonatal outcome showed no significant difference by day of delivery.Conclusions: Our results contradict the idea that deliveries on weekends and holidays are more risky for patients and their children

About a case of a specific complication of monoamniotic twin pregnancy: umbilical cord entanglement

Monoamniotic twin pregnancies are uncommon and often complicated by umbilical cord entanglement. It is important to investigate a umbilical cord entanglement during antenatal ultrasound examinations. The diagnosis is based on ultrasound with color and pulsed Doppler. Despite the high percentage of cord entanglement, the perinatal mortality rate remains very low. Rigorous ultrasound monitoring and recording of fetal heart rhythms can improve the prognosis. We report a case of umbilical cord entanglement in a monoamniotic twin pregnancy discovered during a caesarean section with a favorable outcome