Incidence and outcome of severe ante-partum hemorrhage at the Teaching Hospital Yalgado Ouédraogo in Burkina Faso

Abstract

BackgroundHemorrhage is the main cause of maternal death during pregnancy. This study aims to evaluate incidence and outcomes of Severe Ante Partum Hemorrhage (SAPH) during the third trimester of pregnancy prior to delivery.MethodsAnalytical cross-sectional study with prospective data collection during 12 months in Yalgado Ouedraogo Hospital, Ouagadougou, Burkina Faso. In this context SAPH is specifically referring to Ante Partum Hemorrhage (APH) and Intra Partum Hemorrhage (IPH) in the 3rd trimester. Postpartum Hemorrhage (PPH) was not included.ResultsDuring our study 7,469 women were admitted in obstetrics and 122 cases of SAPH were recorded. SAPH represented 1.6% (n = 122) of hospitalizations causes and 14.5% (n = 1083) of hemorrhages during pregnancy. Mean age was 27.8 ± 6.9 years, mean parity 2.8 ± 1.3 and mean duration of pregnancy was 37 Weeks Amenorrhea (WA). Evacuation from other facilities was the main mode of admission (91.8%, n = 112) and blood transfusion was the essence of resuscitation. Complications were observed in 80.3% (n = 98). During the study, 118 maternal deaths were reported of which 15.6% (n = 19) related to SAPH. Among SAPH cases who died (n = 19) majority (n = 16) had severe anemia (n = 16; 82.6%, p = 0.004). Ten women (8.19%) were admitted in Intensive Care Unit (ICU). Fifteen premature births (12.3%) and 22 perinatal deaths (18.1%) were recorded. Evacuation (p = 0.04), critical clinical condition during admission (p = 0.004), and Uterine Rupture (UR) (p = 0.002) were associated with poor outcome. The Retroplacental Hemorrhage (RPH) (40.9%) was the most common cause of fetal death (p = 0.005) and was associated with High Blood Pressure (HBP) and pre-eclampsia.ConclusionAPH is a complication associated with significant maternal and fetal morbidity and mortality.

A study of risk factors and obstetric outcome of antepartum haemorrhage in a tertiary care hospital of eastern India

“…The study conducted by Wasnik SK et al 2 found, rate of caesarean section was 90% in their APH group. In a similar study, reported by Lankoande M et al, 14 it was found rate of caesarean section in placenta praevia and abruptio placentae (i.e. retro placental hematoma) were 56.9%, 43.1% and vaginal birth in placenta praevia and abruptio placentae were 66.6%, 33.4% respectively.…”

Effect of Maternal Disease and Antepartum Blooding on Neonatorum Asphysia

“…This is because the placenta is the root of the fetus to suck nutrients from the mother in the form of O2, amino acids, vitamins, minerals and other substances to the fetus and remove the products of fetal metabolism and CO2. Impaired gas exchange in the placenta will cause fetal asphyxia [21][22] [23] The results of the study are in accordance with the theory put forward by Mochtar which states that placenta previa is a placenta that implants in the lower uterine segment and covers part or all of the internal uterine ostium. [6] The incidence of placenta previa is 0.4% -0.6%.…”

Fetal and Maternal Outcomes in Women With Major Placenta Previa Among Sudanese Women: A Prospective Cross-Sectional Study

“…Maternal mortality has regional variation, but, generally, it ranges from 5%-7% [12] and in spite of the fact that maternal mortality in sub-Saharan Africa accounts for two-thirds of the global maternal death rate, there was a significant reduction in the maternal mortality ratio (MMR) in north Africa and other parts of the world in the period from 2000 to 2017 [13]. A regional North African descriptive study, which involved 52 cases of major degree placenta previa, reported no maternal deaths and in another cross-sectional study conducted in West Africa, the maternal death rate was as high as 15.6% [14].…”