Aspects épidémiologiques, thérapeutiques et pronostiques de l'hématome rétro placentaire (HRP) à l'hôpital de la mère et de l'enfant de N’Djamena.

Abstract

Introduction: placenta abruption is a major obstetric emergency whose management out of obstetric procedure needs medical resuscitation. It engages maternal and fetal prognosis by despoiling blood that interrupt maternal and foetal exchange
Objective: evaluate management and maternal and foetal prognosis of placenta abruption in N'Djamena mother and child hospital. Patients and method: This was a prospective and descriptive survey for a year (from April 1st, 2014 to March, 31st 2015 perform
at N'Djamena mother and child hospital about epidemiologic, therapeutic aspect and prognosis of abruption placenta. Patients admitted for abruption placenta were included. Results: We have registered 82 abruption placenta among 3,875 deliveries giving a frequency of 2.1%. Medium age was 29.6 the group age from 25 to 29 years were more represented with 35.3%. No schooled
have represented 78% ad 63.4 hadn't attended prenatal consultation. Primiparous represented 40.1 (n=31). The medium term was 37.2± 2.1 weeks. The medium foetal weight was 2980g. Bleeding was more represented among sign recorded at admission with 76.8%. The gravity of placenta abruption was done using classification of Sher. Patients with grade 3 have represented 68.3 %( n56). A clot disorder was observed in 20.7% vagina delivery represented 51% against 49% of cesarean section. Mains maternal
complication was anemia. On maternal death was recorded giving a maternal lethality of 2.4%. Foetal prognosis was enameled by 85.7% Conclusion: abruption placenta is a frequent and obstetric and medical emergency. Maternal and foetal morbidity and mortality often high are linked with the severity of clinical stage. Decrease of this morbidity and mortality maternal need a rapid diagnose and management in adequate structure.