Placental abruption leading to disseminated intravascular coagulation: a clinical case and short review.

We present the case of a primigravida with disseminated intravascular coagulation at 21 weeks' gestation. Furthermore, we performed a short review of the evidence-based management of the condition. The patient presented with pain and vaginal bleeding. Clinical examination, laboratory studies, and an abdominal ultrasound produced inconclusive results about the origin of her disseminated intravascular coagulation. She was transferred to a tertiary facility where blood and plasma product transfusions were performed, and further investigations revealed fetal demise caused by placental abruption as the underlying cause of her disseminated intravascular coagulation. Cervical preparation was conducted with a balloon catheter and misoprostol. Surgical evacuation of her uterus was performed and she made a full recovery.

Perceptions of prenatal and obstetric care in Sub-Saharan Africa.

BACKGROUND: The maternal mortality ratio in Sub-Saharan Africa remains high, despite progress in reducing maternal mortality in other parts of the world. OBJECTIVE: To explore the perceptions of women and communities to identify barriers to the uptake of obstetric services. SEARCH STRATEGY: A systematic review of qualitative studies exploring perceptions of pregnancy and obstetric services, with thematic synthesis of the included studies. SELECTION CRITERIA: Qualitative studies reporting findings from focus group discussions and in-depth interviews between 1996 and 2009 were included. DATA COLLECTION AND ANALYSIS: Thematic synthesis involved collating and reviewing quotations taken directly from included studies. Themes were generated and clustered for analysis. MAIN RESULTS: Twenty-seven studies were included and 6 major themes identified: perceptions of healthcare workers; perceptions of the hospital environment; cultural perceptions of women; cultural perceptions of pregnancy; perceptions of traditional birth attendants and traditional healers; and role of the community in pregnancy and birth. CONCLUSION: Community attitudes regarding cultural beliefs and interactions with healthcare providers were identified as barriers to the utilization of healthcare services during pregnancy in Sub-Saharan Africa. These prevent engagement with prenatal care and timely use of medical services. Addressing the barriers will be seminal to the success of any healthcare intervention.