RESUMO
INTRODUCTION: placenta accretacauses severe postpartum haemorrhage. Our objective is to describe its diagnostic and therapeutic aspects as well as incidence at Timbuktu hospital. OBSERVATION: We have encountered one case of placenta accreta in six years, an occurrence of 1 in 6160 births. The patient was a 25-year-old multiparous woman with a history of a cesarean section, admitted to labor, without ultrasound performed during pregnancy. A placenta accreta was found during the caesarean section which was ordered due to stagnation of dilation. A cesarean section followed by hysterectomy was performed without complication. Anatomopathological examination confirmed the diagnosis by revealing an increta-type placenta. CONCLUSION: The incidences of placenta accreta are low in our practice. However, thisdiagnosis should always be discussed during prenatal consultationsin cases where anterior placenta is connected to a uterus with scar tissue, in which case an ultrasound is routinely ordered.
INTRODUCTION: le placenta accreta est responsable d'hémorragie grave du post-partum. Notre objectif était de décrire ses aspects diagnostiques, thérapeutiques et son incidence à l'hôpital de Tombouctou. OBSERVATION: nous rapportons un cas de placenta accreta sur six ans soit une incidence de 1/6160. Une multipare de 25 ans avec un antécédent de césarienne, admise en travail d'accouchement, sans échographie réalisée pendant la grossesse. La découverte d'un placenta accreta est faite en peropératoire, après indication d'une césarienne pour stagnation de la dilatation. Une césarienne suivie d'une hystérectomie est faite avec des suites opératoires simples. L'examen anatomopathologique a confirmé le diagnostic en retrouvant un placenta de type increta. CONCLUSION: l'incidence du placenta accreta est faible dans notre pratique. Toutefois ce diagnostic doit toujours être évoqué lors des consultations prénatales en cas de placenta antérieur sur utérus cicatriciel et une échographie demandée systématiquement.
RESUMO
Eclampsia is one of the leading causes of maternal death worldwide. The purpose of our study was to determine maternal and perinatal prognosis of eclampsia at the Timbuktu Hospital in Mali. We conducted a descriptive, retrospective study of patients with eclampsia during pregnancy or delivery at the Timbuktu Hospital from January 1, 2013 to December 31, 2017. Out of 4.951 deliveries, 116 were marked by eclampsia, reflecting an overall rate of 2.3%. These patients were mainly women younger than 26 years (85.3%), primiparous (81%), admitted on average 8 hours after the first crisis. Cesarean section was performed in 77.6% of cases. Magnesium sulphate was used in 75% of cases. Maternal and perinatal mortality accounted for 4.3% and 21.5%, respectively. Poor maternal prognosis factor was Glasgow score ≤ 8 on admission (p: 0.004). Poor perinatal prognosis factors were to be resident outside the city of Timbuktu (p: 0.000), the absence of antenatal consultation (p: 0.020) and vaginal delivery (p: 0.012). Thus, improving maternal and perinatal prognosis requires proper monitoring of pregnancies and reduction of delays in accessing adequate care.