• Hanane Bouchghoul, Emmanuel Hornez, Xavier Duval-Arnould, Henri-Jean Philippe, and Jacky Nizard.
• Department of Obstetrics and Gynecology, Hospital Group Pitié-Salpêtrière, AP-HP, Paris, France.
• Acta Obstet Gynecol Scand. 2015 Jul 1;94(7):755-9.

ObjectiveTo report the first 6 months of experience of a nongovernmental-organization-managed obstetric care unit in a war refugee camp, with problems encountered and solutions implemented.DesignProspective observational study of the maternity activity of Gynécologie Sans Frontières (GSF).SettingGSF's maternity unit, in Zaatari camp (Jordan).PopulationAll pregnant women among Syrian refugees who came to the unit for delivery.MethodsThe GSF's maternity unit is a light structure built with three tents, permitting low-risk pregnancy care and childbirth. Emergency cesarean deliveries were performed in the Moroccan army field hospital. High-risk pregnancies were transferred to Al Mafraq or Amman Hospital (Jordan) after assessment.Main Outcome MeasuresDelivery characteristics, indications for referral.ResultsFrom September 2012 to February 2013, 371 women attended the unit and 299 delivered in it. Delivery rates increased from 5/month to 112/month over the period. Mean gestational age at birth was 39(+3) gestational weeks (SD = 1.9). Median birthweight was 3100 g (25-75% interquartile range 2840-3430 g). Spontaneous vaginal deliveries were dominant and the major maternal complication was postpartum hemorrhage (n = 13). Eighty-two women were referred to Al Mafraq or Amman hospitals, mainly for preterm labor (32%) and congenital malformations (11%). We managed one case of stillbirth. Maternal mortality did not occur.ConclusionsDespite the difficulties of war, high-risk pregnant women were properly identified, permitting referrals when required. Cooperation with other nongovernmental organizations, including the United Nations High Commissioner for Refugees, was essential for the management of situations at risk of complications and to contain perinatal and maternal mortality.© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

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