[Placenta praevia: maternal and featal prognosis in University Hospital of Cocody (Abidjan-Cote d'Ivoire)].

INTRODUCTION

In Africa, in spite of systematical practice of echography, Placenta praevia (PP) remains a high risky gravid complication, very unpredictable, with a high lethality rate.

OBJECTIVES

The aim of our study was to reconsider the frequency of this pathology, to appreciate the maternal and fetal prognosis.

PATIENTS AND METHODS

This was a retrospective cohort study, about 340 cases of PP, at the University Hospital of Cocody in Abidjan, during 5 years, from January 1st 2002 to December 31st 2006. We included in this study all the parturients with a gestational age > or = 28 weeks of amenorrhea, and a PP diagnosed during either pregnancy, or labour, or after placenta stage. Maternal age, parity, gynecologic and obstetrical antecedents, mode of delivery and maternal and fetal prognosis was compared between patients with PP and a group of witness chosen among normal pregnancies. The comparison has been done by using X² and Fischer test with a threshold of signification of 5%.

RESULTS

The frequency of PP in our study was 1.6%. The maternal age was > or = 30 years old for 43.2% of patients with PP against 28% in witness group (p=0.000). Among cases of PP, multiparous and high multiparous represented 37.7% against 10% in the witness group. Healing uterus was an increasing factor of PP (32 cases against 8 in witness group; p=0.024). Caesarean operation has been the principal mode of delivery among the patients with PP (80%). 43.8% of newborn was premature against 8.5% in the witness group (p=0.0000). The perinatal mortality was 21.3% in cases of PP against 3.8% in witness group. Three maternal deaths (0.9%) have been noticed among patients with PP.

CONCLUSION

The management of PP is still badly definite in Africa. The early diagnostic by ultrasound examination permit an adapted supervision and the prevention of all obstetrical complications of this pathology.