Anomalies of Placentary Insertion (API) at Bogodogo university hospital in Ouagadougou, Burkina Faso: Epidemiological, clinical and prognostic aspects

Abstract

Objective: To study the epidemiological, clinical and prognostic aspects of placental insertion anomalies in Ouagadougou hospitals. Patients and Methods: This was a two-year retrospective study, from January 1, 2021 to December 31, 2022, at the Bogodogo University Hospital in Ouagadougou. We included in this study all patients carrying a pregnancy with a gestational age ≥28 weeks of amenorrhea in whom the diagnosis of placental insertion anomaly was made. Information was collected from admissions registers, clinical records and operative protocols.Results: We recorded 389 cases of API in 33137 deliveries, representing a frequency of 1.17%. Placenta previa was the most common, followed by placenta accreta with frequencies of 1.13% and 0.03%. The mean age of patients was 28.5 [17-48] and mean parity 2.1 [0-10]. Of these, 95.5% were couples and 70% housewives. In addition to age, gestational age and parity, other risk factors included a history of abortion (21.2%), caesarean section (11.3%) and male foetus (55%). Twin pregnancies (6.18%) were only associated with PP. The mean age of pregnancy was 36.1 week of amenorhoea [28-41] and abnormal presentations 24%. Overlapping PP represented 62% and placenta increta (2 cases out of 13). Blood transfusion was performed in 26% of patients, caesarean section 65.8% and 2 hysterectomies. The average length of stay was 4.2 days [1-29]. No maternal deaths were recorded. Anemia, hemorrhage and infection were the main maternal complications observed in 20.6% of cases. Stillbirths were 22.2%, neonatal morbidity 46.8%, and transfers to neonatology 23.5%.Conclusion: API is a serious and frequent pathology of pregnancy. Early ultrasound diagnosis and timely Caesarean section are essential to improve maternal and fetal prognosis.