Pediatrics in the Maternity Unit at the Teaching Hospital Gabriel Touré of Mali: Results of a Year of Activities

Abstract

Introduction: Pediatrics in maternity unit is a particular mode of practice of neonatology, which cannot be reduced to the simple transposition, in an obstetric environment, of neonatal practice performed in a pediatric environment, let alone in a neonatal resuscitation environment. 

Methodology: It was a retrospective study over 12 months from January 1st to December 31st , 2018. Data were collected from birth records, newborn resuscitation and newborn follow-up registers. The variables studied were the indication of the call for a pediatrician, the delivery route, the pediatrician's actions according to the ILCOR's recommendations, the reason for transfer to the neonatology and the fate of newborns.  Results: Over the year, 3168 deliveries were made, of which 38.16% (n = 1209) by caesarean section. The pediatrician was asked for 590 deliveries that led to the management of 641 newborns. The main reason for the calls was cesarean delivery (81.4%). The main indications for Caesarean section were severe pre-eclampsia (24.1%), eclamptic crisis (21%) and scarred uterus (16.4%). For the majority of newborns, or 63.6% (n = 408), the management stopped at phase A of ILCOR. It continued to phase B and C in 21.5% (n = 151) and 8.4% (n = 54), respectively. Resuscitation failure was observed in 10 newborns (1.6%). In 47.1% of cases (n = 302), neonates were transferred to the neonatal department. The main reasons for transfer were preterm birth (66.2%), perinatal anoxia (15%) and respiratory distress (4.6%). In neonatology, the mortality rate was 14% (n = 42). Conclusion: The pediatric activity in the maternity unit has permitted the management of a large number of newborns from birth at Gabriel Touré Teaching Hospital. Its regular evaluation will improve it and ensure better survival of newborns.