Retroplacental hematoma (RH): therapeutic epidemiological aspects, and prognostics about 58 cases at the maternity of the Owendo university hospital

Abstract

Objectives: To describe the epidemiological aspects of retroplacental hematoma at the maternity of the University Hospital of Owendo.

Patient and methods: A retrospective and descriptive study conducted at the CHU of Owendo over 4 years. The period from January 1, 2017 to December 31, 2020. All records of patients who had HRP were included. For each patient, we studied socio-demographic parameters, clinical, therapeutic data and maternal-fetal prognosis.

Results: We identified 58 cases of HRPout of 12214 deliveries, a frequency of 0.47%. The mean age of patients was 31.2 years. Unemployed patients accounted for 63.7% of cases. A very small proportion of pregnancies were unattended and 13.8% of cases. Patients came from home in 74.1% of cases. Abdominopelvic pain was the main complaint in 87.9% of cases. At admission, foetal heart sounds were audible in 60.34% of patients and the majority of patients had a dilated cervix. Caesarean section was the preferred mode of delivery 91.38%. The severity of the clinical picture was assessed intraoperatively according to Sher's classification with 51.9% (30 cases) at grade 3. We noted one case of maternal death, or 1.7% of patients. We deplored the loss of 9 newborns during intra-hospital care.

Conclusion: Despite many diagnostic and therapeutic advances, retroplacental hematoma is still a dramatic obstetric accident at the end of pregnancy. The reduction of maternal and foetal mortality related to this condition requires better prenatal monitoring, better organization of the delivery plan and the availability of labile blood products within hospital structures.