Placental Abruption: Management in a Low Resource Setting Country

Abstract

This chapter aims to describe the epidemiological, clinical and prognostic factors and assess treatment of placental abruption in the obstetrics gynecology department of the Dakar Principal Hospital, Senegal.

This retrospective observational study included 130 successive cases of placental abruption, which occurred from January 2015 to December 2017 at the Level 3 Maternity Unit of the Dakar Principal Hospital. The information was gathered from non-computerized obstetric records and analysed with Excel and Epi info software.  There were 130 incidences of placental abruption, which represents a 1.5% frequency.  The average age of onset of placental abruption was 30 years. The history of hypertension concerned 32.3% of patients, the average gestational age of 32.5 weeks at the time of diagnosis, grade 3 of Sher found in 48.5% of cases. The pregnancy resulted in a caesarean section in 79.2% of cases, with newborns weighing an average of 2058g. The complications necessitated a blood transfusion as well as intensive care. A haemostasis hysterectomy was performed in 6.2% of cases. Stillbirth rate was 53.7% and zero maternal mortality.  Based on the finding of this study, it can be concluded that Placental abruption, a severe complication of pregnancy, is associated with high perinatal morbidity and mortality linked to the severity of the clinical picture, despite an improved maternal prognosis.