Introduction: Placental abruption is a severe and unpredictable obstetric emergency that threatens
both maternal and fetal life. The aim of this study was to describe the epidemiological, clinical, and
therapeutic aspects of Placental abruption in a rural setting in Mali.
Materials and Methods: This was a prospective case-control study conducted at the Reference Health
Center of Sikasso, southern Mali, over 15 months (July 2020–August 2021). Fifty-one (51) cases of
Placental abruption were compared with 102 controls (1:2 ratio). Data were collected prospectively
and analyzed using SPSS version 25. The Chi-square test was used to assess associations between
qualitative variables.
Results: Out of 6,387 deliveries, 51 cases of Placental abruption were recorded (0.79%). Vaginal
bleeding was the main reason for admission (54.9%). According to Sher’s classification, grade
IIIa was the most frequent (58.8%). Cesarean section was performed in 90.2% of cases (OR=42.9;
p=0.001), including 25 procedures for maternal rescue. Blood transfusion was required in 43.1% of
cases (OR=37.9; p=0.001). Maternal complications were dominated by anemia (68.6%), postpartum
hemorrhage (23.5%), coagulation disorders (2%), and shock (2%). Perinatal complications included
low birth weight, prematurity, and stillbirth (62.7%; OR=55.57; p=0.000), with 7.8% neonatal deaths.
Conclusion: Placental abruption remains a major obstetric emergency due to its sudden and
unpredictable onset. Cesarean section and blood transfusion are the main therapeutic interventions.
Maternal morbidity is mainly due to anemia and postpartum hemorrhage, while perinatal mortality
remains high. Preventive strategies should focus on strengthening antenatal care, improving delivery
planning in rural areas, ensuring efficient referral systems, establishing functional blood banks and
intensive care units, and enhancing neonatal care services.
