Pregnancies without Prenatal Care in the Health District of Commune V in Bamako: Obstetrical Prognosis

Summary: We attempted to determine the obstetric prognosis of women without antenatal care in the Health District of Commune V of Bamako, Mali. Materials and Methods: We undertook this retrospective case-control study from January 1 to March 31, 2017. Of all women having given birth to during this period in this district, we compared characteristics and obstetric outcomes between women without antenatal care (study group) vs. those with antenatal care (age/parity matched control). Results: 13.8% of women were without antenatal care (23.45 ± 9.56 years of age: 13 - 42). Study group (without antenatal care), compared with control, was significantly more likely to be household helpers (OR = 2.5 [2.0 - 3.4]) and single (OR = 2.3 [1.8 - 2.8]). Study group women were more significantly likely to have the following poor obstetric outcomes: premature rupture of the membranes, post-maturity, low birth weight, hypertensive disorders of pregnancy, uterine rupture, fetal death, anemia, fetal malposition, cesarean section, postpartum hemorrhage, puerperal infection and maternal death. Study group showed a higher risk of early neonatal death, low Apgar score, and transfer to Neonatology institute. Conclusion: In accordance with the previous reports in any other countries, no prenatal checkup causes higher poor outcome of both mothers and infants/neonates also in this area.

Practice of Essential Care for Newborns in the Referral Health Center of Commune 5 of Bamako District

Introduction: Delay in recognizing newborn health problems and delay in accessing quality care contribute to a high number of newborn deaths. The objective of this work was to study the practice of essential newborn care. Patients and method: This was a descriptive study on critical care newborns at the referral health Center of the Commune 5 (CSRéf C5) Bamako from 1st April to 31 May 2018. The acquisition, processing and data analysis were done on SPSS software. Results: The average age of the patients was 24.8 years. They were out of school and knew about the importance of prenatal consultations (83.3%). The majority of health workers were Nurses and Obstetricians (59.3%). The effective care (100%) given to the newborns was anthropometric measurements of the newborn and identification of the newborn. Treatments such as stimulated drying, skin-to-skin contact, warming, and administration of vitamin K1 were each administered at over 90%. The fight against heat loss by the head (14.1%) and early latching (41.5%) were insufficiently administered. Cord care was not provided at the Hospital prior to discharge for contextual reasons. The administration of ocular antiseptics was not administered in the hospital. Conclusion: The administration of essential newborn care at the referral health Center of the Commune 5 in Bamako has shortcomings.