Obstetrical complications treated in the maternities of the region of Sousse (Tunisia)

Abstract Background About 800 women die each day worldwide due to complications related to pregnancy, childbirth or in the postpartum period. The objective of this study was to describe the activity of the public maternities in the Governorate of Sousse (Tunisia) and to identify obstetrical complications treated in these facilities. Methods A cross sectional study of all public health facilities, which performed deliveries in Sousse was conducted in 2017 (Five maternities: one University maternity and four peripheral ones). Data were collected by reviewing clinical records and registers of these maternities for the year 2016. Results In total, in the health visited structures, there were 13427 deliveries in 2016, the majority of them (78.8%) took place at the university maternity of Farhat Hached hospital. Of these deliveries, 3397 were performed by caesareans (25.3%). In 2016, there were three maternal deaths and 69 very early neonatal deaths. There were 2036 direct obstetric complications treated in the five maternities visited. The most frequently encountered direct complications were: ’obstructed/prolonged labor’ (41.21%), ’severe pre-eclampsia/eclampsia’ (19.5%) and ’ante and postpartum haemorrhage’ (15.18%). The most encountered indirect obstetrical complications were: gestational diabetes and anaemia. Conclusions The reduction of maternal and neonatal mortality requires the existence of a functioning basic health care system that provides all pregnant women and their newborns with timely access to skilled care, particularly when a complication occurs. The provision of this qualified care requires also the presence of qualified personnel working in a suitable professional environment. Key messages The majority of obstetrical complications occur in university maternity and this is due to excessive references from peripheral maternities. Peripheral maternities need to be strengthened with material and human resources.