Hemorrhagic Placenta Previa: Epidemiology, Clinical and Prognostic Aspects in the Maternity Ward of Sominé Dolo Hospital, Mopti, Mali

Abstract

Introduction: Placenta previa is a complication of pregnancy, corresponding to the insertion of Anor male insertion of the placenta into the lower segment of the uterus. The objective of our study was to determine the frequency of hemorrhagic placenta previa, its epidemiological and clinical profile and its maternal-fetal prognosis in the maternity ward of Sominé Dolo Hospital. Methods: This was a descriptive cross-sectional survey type study of 40cas collated with hemorrhagic placenta previa ranging from February 1, 2016 to January 31, 2017, a 12-month period. Data were entered and analyzed on SPSS software (version 16 .0). Results: During the study period we collected on 946 deliveries of which 54 cases of placenta previa among which 40 cases were hemorrhagic placentas previa that is a prevalence of 4.2%. The age group 19-35 years represented 50% of the cases. The epidemiological profile was that of married women (80% of cases), housewives (50% of cases), and multiparous women (45% of cases). The delivery by high route was practiced in 87.5% of the cases and the main indications were placenta previa covering, hemorrhage despite amniotomy in labor, breech presentation and acute fetal distress with respectively 70%, and 6% of the cases for the last three indications each. Fetal mortality was represented by 25% of cases. Maternal complications were represented by hemorrhagic shock and delivery hemorrhage with respectively 60% and 40% of cases. Conclusion: Hemorrhagic placenta previa is nowadays a dreadful event that can jeopardize the maternal and fetal prognosis. Rapid management by a multidisciplinary team composed of obstetricians, resuscitators, neonatologists and biologists, could improve the maternal and fetal prognosis.