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[Abruptio placentae: epidemiological, clinical and prognostic aspects with respect to a 177 case series]
B Thieba1, J Lankoande, M Akotionga
1Service de gynécologie-obstétrique, centre hospitalier national Yalgado-Ouédraogo, BP 6428, Ouagadougou, Burkina Faso. thieba@fasonet.bf
Insights
Abruptio placentae, a serious pregnancy complication, significantly impacts maternal and fetal outcomes. Early diagnosis and prompt intervention are crucial for reducing mortality and morbidity.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Reproductive Health
Context:
- Retrospective analysis of 177 abruptio placentae cases at CHNYO, Ouagadougou over five years.
- Abruptio placentae incidence rate of 9.6 per 1000 deliveries.
- High-risk demographics identified: women aged 30-34, multiparous women, and those with pregnancy-induced hypertension.
Purpose:
- To describe the epidemiological, clinical, and prognostic aspects of abruptio placentae.
- To analyze maternal and fetal outcomes associated with abruptio placentae.
- To identify key factors influencing abruptio placentae and its consequences.
Summary:
- The study found abruptio placentae most common in women aged 30-34 (31.1%) and multiparous women (56.5%).
- Severe cases (grade 3) with fetal demise were frequent (83.1%). Maternal mortality was 3.9%, primarily due to anemia and infection.
- Fetal prognosis was poor, with a high stillbirth rate of 85.9%.
Impact:
- Highlights the critical need for improved prenatal care, timely diagnosis, and prompt management of abruptio placentae.
- Emphasizes the significant risks of maternal mortality and fetal loss associated with this condition.
- Informs clinical practice and public health strategies aimed at mitigating the adverse effects of placental abruption.
Objective:
A retrospective study based on 177 cases of abruptio placentae, and describing the epidemiological, clinical and prognosis aspects.
Patients And Methods:
A hundred and seventy-seven cases, corresponding to 185 children, were registered over a five-year period in the department of gynecology and obstetrics of the CHNYO of Ouagadougou.
Results:
Abruptio placentae occurrence rate was about 9.6 per 1000 deliveries. In our study, this type of accident was most frequent with 30 to 34-year-old women (31.1%), with multiparous ones (56.5%), and with those suffering from arterial hypertension linked to pregnancy (31.1%). The clinical picture was most often complete, 83.1% of patients having reached grade 3 of abruptio placentae with complete symptomatology and foetal death. Vaginal delivery was preferred to cesarean section in 64.4% of the cases. Maternal death rate was about 3.9% and mainly caused by severe anemia (61.6%) and puerperal infections (7.9%). Foetal prognosis was dominated by the high rate of mortinatality (85.9%).
Discussion And Conclusion:
To reduce maternal mortality as well as morbidity due to abruptio placentae, correct prenatal follow-up, early diagnosis and prompt evacuation of the womb are required.
