[ Hématome retro-placentaire et mort fœtale in utero: A propos de 49 cas et revue de la littérature ]
Volume 3, Issue 2, June 2013, Pages 570–578
Saida Mezane1, M. Achnani2, M. Ziyadi3, Abdellah Babahabib4, R. Hafidi5, Driss Moussaoui6, and Mohammed Dehayni7
1 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
2 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
3 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
4 Service gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohamed V, Rabat, Morocco
5 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
6 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
7 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2013 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The Retro Placental Hematoma (RPH) or placental abruption untimely normally inserted paroxysmal is an accident that threatens maternal and fetal prognosis. It is a major emergency obstetric pathology and remains the second leading cause of maternal mortality after postpartum haemorrhage. It is actually very difficult to have an accurate evaluation the frequency of the HRP because it requires a complete table including Pathologists; or simple macroscopic or microscopic findings; or purely clinical diagnosis for some. Its occurrence requires appropriate resuscitation and adapted care to improve the prognosis. We report our study of 49 cases the HRP hospitalized in Obstetrics and Gynecology of Instruction Military Hospital Mohamed V in Rabat, diagnosed on a suggestive clinical picture and the presence of hematoma after examining the issue. This is a descriptive and comparative retrospective study over a period of one year. This study compared two groups: with HRP feotale death in utero and HRP without fetal death in utero. This study aims to evaluate neonatal mortality and maternal morbidity related to RPH and therapeutic modalities. This pathology formerly known pathology multiparous tends to reach more and more heifer. The important blood loss and delay the expulsion worse prognosis causing severe maternal morbidity hence the need to expand the indications for cesarean of retro placental hematoma regardless of the fetal state. Our study aims to contribute to reduce mortality and morbidity Fetomaternal by improving our work is stepping up efforts for a rapid decision-making, and we must educate what especially pregnant women of the risk factors to see from the beginning of symptoms. The pregnancy monitoring, early diagnosis of RPH, an obstetrical treatment adequate, and a resuscitation well driving can improve the prognosis of this disease.
Author Keywords: Retro Placental Hematoma, Fetal Death In Utero, Maternal Prognosis, Complications, Treatment.
Volume 3, Issue 2, June 2013, Pages 570–578
Saida Mezane1, M. Achnani2, M. Ziyadi3, Abdellah Babahabib4, R. Hafidi5, Driss Moussaoui6, and Mohammed Dehayni7
1 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
2 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
3 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
4 Service gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohamed V, Rabat, Morocco
5 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
6 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
7 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2013 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The Retro Placental Hematoma (RPH) or placental abruption untimely normally inserted paroxysmal is an accident that threatens maternal and fetal prognosis. It is a major emergency obstetric pathology and remains the second leading cause of maternal mortality after postpartum haemorrhage. It is actually very difficult to have an accurate evaluation the frequency of the HRP because it requires a complete table including Pathologists; or simple macroscopic or microscopic findings; or purely clinical diagnosis for some. Its occurrence requires appropriate resuscitation and adapted care to improve the prognosis. We report our study of 49 cases the HRP hospitalized in Obstetrics and Gynecology of Instruction Military Hospital Mohamed V in Rabat, diagnosed on a suggestive clinical picture and the presence of hematoma after examining the issue. This is a descriptive and comparative retrospective study over a period of one year. This study compared two groups: with HRP feotale death in utero and HRP without fetal death in utero. This study aims to evaluate neonatal mortality and maternal morbidity related to RPH and therapeutic modalities. This pathology formerly known pathology multiparous tends to reach more and more heifer. The important blood loss and delay the expulsion worse prognosis causing severe maternal morbidity hence the need to expand the indications for cesarean of retro placental hematoma regardless of the fetal state. Our study aims to contribute to reduce mortality and morbidity Fetomaternal by improving our work is stepping up efforts for a rapid decision-making, and we must educate what especially pregnant women of the risk factors to see from the beginning of symptoms. The pregnancy monitoring, early diagnosis of RPH, an obstetrical treatment adequate, and a resuscitation well driving can improve the prognosis of this disease.
Author Keywords: Retro Placental Hematoma, Fetal Death In Utero, Maternal Prognosis, Complications, Treatment.
Abstract: (french)
L'hématome rétro placentaire (HRP) ou le décollement prématuré du placenta normalement inséré est un accident paroxystique qui menace le pronostic maternel et fœtal. Il constitue une urgence majeure en pathologie obstétricale et demeure la deuxième cause de mortalité maternelle après les hémorragies de la délivrance. Il est en fait très difficile de disposer d'une évaluation précise de la fréquence de l'HRP car la définition des auteurs varie selon le mode de diagnostic pare ce qu'il nécessite un tableau complet incluant l'anatomopathologie, ou simples constatations macroscopiques ou microscopiques, voire diagnostic purement clinique pour certains. Sa survenue nécessite une réanimation appropriée et une prise en charge adaptée afin d'améliorer le pronostic de cette pathologie. Nous rapportons notre étude de 49 cas d'HRP hospitalisés dans le service de la Gynécologie-Obstétrique de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, diagnostiqué sur un tableau clinique évocateur et la présence de l'hématome après examen du délivre. C'est une étude rétrospective descriptive et comparative sur une durée d'une année. Cette étude compare deux groupes : HRP avec mort fœtale in utero et HRP sans mort fœtale in utero.
Le but de cette étude est d'évaluer la mortalité néonatale et la morbidité maternelle liée à l'HRP ainsi que les modalités thérapeutiques. Cette pathologie anciennement connue pathologie de la multipare tend à atteindre de plus en plus la primipare. La spoliation sanguine importante et le retard à l'expulsion aggravent le pronostic entrainant une morbidité maternelle grave, d'où l'intérêt d'élargir les indications de césarienne pour hématome rétro placentaire quel que soit l'état fœtal. Notre étude vise à contribuer à la réduction de la mortalité et de la morbidité fœto-maternelle par l'amélioration de notre travail on multipliant les efforts pour avoir une rapidité dans la prise de décision et il faut sensibiliser les femmes enceintes surtout qu'ont des facteurs du risque de consulter dès le début des symptômes.
Le suivi des grossesses, le diagnostic précoce de HRP, une prise en charge obstétricale adéquate et une réanimation bien conduite amélioreraient le pronostic de cette pathologie.
Author Keywords: Hématome Rétro Placentaire, Mort Fœtale In Utero, Complications, Pronostic Maternel, Traitement.
How to Cite this Article
Saida Mezane, M. Achnani, M. Ziyadi, Abdellah Babahabib, R. Hafidi, Driss Moussaoui, and Mohammed Dehayni, “The retro placental hematoma and fetal death in utero: About 49 cases and review of the literature,” International Journal of Innovation and Applied Studies, vol. 3, no. 2, pp. 570–578, June 2013.
