Hemorrhages in the last trimester of pregnancy: epidemiological, clinical aspects, management and prognosis at the maternity ward of the Coyah prefectural hospital.

Abstract

The objectives of this study were to calculate the frequency of bleeding in the third trimester of pregnancy, to describe the sociodemographic, clinical, therapeutic and prognostic characteristics. Patients and method: This was a prospective descriptive study that took place at the maternity ward of the Coyah Prefectural Hospital from January 1, to December 31, 2021. Results: We recorded during the study period 4151 deliveries including 225 cases of hemorrhage in the third trimester of pregnancy, a frequency of 5.42%. The socio-demographic profile was that of a woman in the age group of 25-29 years (30.67%), poor (39.11%) of rural origin (82.67%), married (76.89%), housewife (76.89%), uneducated (73.78%), evacuated (83.78%) The clinical signs were dominated by metrorrhagia found in all patients (100%), abdominopelvic pain like uterine contractions (82.22%), followed by conjunctival pallor (59.56%) and an alteration of general condition (50.22%) The causes of these haemorrhages were dominated by retroplacental hematoma (52%), followed by placenta previa (31.56%) and uterine rupture (16.44%). Therapeutically, management was based mainly on caesarean section (88%) and the administration of blood products (43.5%). Maternal complications were dominated by anemia (43.56%) followed by hemorrhagic shock (13.78%) and fetal complications by acute fetal asphyxia (33.33%). The maternal lethality rate was 1.78% and that of the fetus 50.67%. Conclusion: Last trimester hemorrhage is an important source of maternal and fetal morbidity and  mortality. Improving the prognosis requires access to comprehensive emergency obstetric and neonatal care.