Postpartum Acute Renal Failure: Experience of the Maternity Ward at the Ziguinchor Regional Hospital Center over a 3-Year Period

Abstract

Introduction: Postpartum acute renal failure (PP-AKI) is responsible for significant maternal and fetal morbidity and mortality. It remains very high in developing countries, where it is around 15% to 20%. The objectives of our study were to determine the prevalence and the epidemiological, clinical, therapeutic, and evolutionary aspects of Postpartum acute renal failure. Patients and Methods : This was a retrospective descriptive and analytical study covering a three-year period (January 1, 2019, to December 31, 2021) conducted at the maternity ward of the Ziguinchor Regional Hospital. The study included all records of patients admitted to the maternity ward in the postpartum period who presented with acute renal failure. The KHI2 test or FISHER test was used to study the correlation of each element with mortality. Results: Eighty-one patients were included during the study period, representing a hospital prevalence of 5.08%. The average age of the patients was 28.19 years. High blood pressure was noted at 50.6%, and herbal medicine was used at 25.9%. The average number of pregnancies and births was 3 each. Prenatal consultations were performed in 28.9% of cases. The average blood urea level was 0.87 g/L, and the average creatinine level was 35.5 mg/L. Retroplacental hematoma was the most common etiological factor in 27.2% of cases, followed by preeclampsia in 24.7%. The outcome was favorable, with complete recovery in 66.7%, partial recovery in 8.7%, and no recovery in 2.5%. Death occurred in 24.6% of cases. Preeclampsia, altered consciousness, respiratory distress, and anuria were significantly associated with maternal mortality. Conclusion: The prevalence of PP-AKI remains low in our study. It is a factor in maternal and fetal morbidity and mortality. The factors associated with this mortality have been identified. Hence, the importance of good prevention.