Maternal and Fetal Complications of Pregnancies Not Monitored at the Diéma Reference Health Center in Mali in 2023

Introduction: Unmonitored pregnancies increase the occurrence of maternal and fetal complications. This study aimed to evaluate the complications of unmonitored pregnancies at the Diema Reference Health Center (CSRef). Methods: This was a retrospective cross-sectional data collection study for all cases of unmonitored pregnancies recorded in the maternity ward of the Diema CSRef from February 1, 2021, to April 31, 2022. The study focused on the records of women who gave birth but did not receive prenatal care (ANC) during their pregnancy. The sample size was 263. Data were entered into KoboToolbox and analyzed using SPSS. The survey forms were coded to ensure anonymity. Results: The proportion of unmonitored pregnancies was 20.4%. Maternal complications were dominated by hemorrhages (57.6%), fetal distress (13.3%), malaria (9.4%), hypertension with its complications (9.4%), and anemia (23%). Fetal mortality was 47%. Regarding fetal complications, the poor Apgar score was 34.4%, including 18.4% stillbirths. Prematurity was 60%, low birth weight 4%, macrosomia 3%, malformations 2%, and neonatal infections 3%. Fetal mortality was 47%. Conclusion: Unmonitored pregnancies represent approximately one-fifth of deliveries in Diema. Maternal complications were primarily hemorrhages, acute fetal distress, malaria, hypertension, and its complications. The fetal prognosis was dominated by prematurity and stillbirths. These complications can be avoided by regular monitoring of prenatal care.