title: [Unmet obstetrical needs for major obstetric interventions in Dakar].
abstract: OBJECTIVE
  To determine unmet needs formajor obstetric interventions and evaluatematernal and perinatal outcome in the region of Dakar in 2010.
  
  
  METHODS
  This retrospective, descriptive, and analytic study of major obstetric interventions (MOI) for absolute maternal indications (AMI) in Dakar examined records in the reference health centers and public hospitals in Dakar for 2010.
  
  
  RESULTS
  During the study period, we recorded 5 383 MOI. The epidemiological profile of patients was a woman with a mean age of 28 years, primiparous (41.1%), married (99.7%), and living more than 10 km from the clinic (51%). AMI accounted for 3 449 of the MOI. Cesarean deliveries were by far the predominant intervention (98.74%). Fetal-pelvic disproportion was the most frequent AMI in our study (75.85%). Because the expected number of MOI for AMI in Dakar was 2123, we estimated an unmet obstetric need (UON) of 1326 IOMs, that is, -62.45%of the excess number of IOMs, with disparities between districts. Of 22,349 deliveries, 47 mothers died (0.21%), mainly from antepartumand postpartum hemorrhages (59.6%) and preeclampsia/eclampsia (23.4%). In all, in 22,349 births, there were 442 deaths (2%).
  
  
  CONCLUSIONS
  Obstetric needs are generally well supported in Dakar. However, this negative deficit recorded may mask a real obstetric need.
authors.affiliation: EPS1 Institut d'hygiène sociale, avenue Malick Sy, 6095 Dakar, Sénégal.
authors.forename: M M
authors.initials: MM
authors.lastname: Niang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008428:Maternal Mortality; D008875:Middle Aged; D013513:Obstetric Surgical Procedures / Q000706:statistics & numerical data*; D054238:Perinatal Mortality; D011247:Pregnancy; D012189:Retrospective Studies; D012675:Senegal; D055815:Young Adult
keywords: Senegal; cesarean deliveries; maternal mortality; perinatal mortality; unmet obstetric needs