Retroplacental Hematoma at the Souissi Maternity Hospital in Rabat (About 60 Cases)

Abstract

Retroplacental hematoma constitutes a major medical-obstetrical emergency, of unpredictable occurrence, putting at risk the vital and functional fetomaternal prognosis. Our work is a retrospective study of 60 cases of retroplacental hematoma that occurred at the Souissi Maternity Hospital in Rabat. These cases were identified from a total of 16864 deliveries, which represents a frequency of 0.35%. The main reason for admission was metrorrhagia. Among the etiological factors found, arterial hypertension dominated with a frequency of 40%. The average age of the patients was 28.31 years and 50% were primiparous. In 60% of the pregnancies, RPH occurred between 32 and 36 weeks of age. The diagnosis was made before birth in 65% of the cases, while in 36.66% of the cases the diagnosis was made only after the delivery examination. The classic form was found in 15% of cases. Therapeutic management was based on reanimation measures and uterine evacuation, taking into account the obstetrical and evolutionary circumstances of the retroplacental hematoma. Finally, the fetal prognosis was dominated by perinatal mortality, whereas the maternal prognosis was quite good overall, with no deaths. The improvement of the fetomaternal prognosis requires a better prenatal follow-up, an early diagnosis, and a rapid evacuation of the uterus without delay.