OBSTETRIC TRANSFERS AND MATERNAL MORTALITY - A STUDY IN CONAKRY, GUINEA

In Conakry (Guinea) we performed a retrospective study to assess the i nfluence on maternal mortality of the transfer of obstetric patients f rom peripheral maternity units to surgical units. From July 1, 1989 to June 30, 1990, we analysed the reproductive history and obstetric tra nsfer conditions of 349 women. Of all the women who gave birth in the six suburban maternity units of Conakry, less than 5% were transferred during the year of the study. Of these 349 transferred women, 25 mate rnal deaths were registered, i.e. approximately one fifth of all the a nnual maternal deaths in Conakry, the capital of Guinea. The diagnosis at the start of transfer from the peripheral maternity unit was rathe r different from the diagnosis mentioned at the admission in the two r eferral maternity units (uterine rupture was the most frequently under -diagnosed condition). In urban areas, maternal mortality related to o bstetric transfer was very often correlated with a lack of appropriate training for midwives and TBAs. A substantial reduction of maternal m ortality levels can certainly be obtained if specific attention to tra ining is given in future international programmes.