Background: Health crises such as H1N1, SARS-CoV-1 and COVID-19 have caused significant psychological effects on healthcare professionals, including stress, anxiety and burnout, which persisted after these crises. The assessment of the impact of pandemics on these professionals and the implementation of prevention and psychological support methods are essential to create a safe work environment and promote social communication. Methods: We conducted a literature review of international studies on H1N1, SARS-CoV-1, and COVID-19, utilizing databases like Google Scholar, PubMed, and Science Direct. Twenty-five studies were considered with a significant concentration in Asia. Discussion: The studies highlighted the significant psychological and behavioral effects of infectious disease outbreaks on healthcare workers during pandemics. Common psychological reported disorders were anxiety, depression, burnout and addiction. Major risk factors influencing included young age, gender, pre-existence of psychological disorders, working in frontline zones and limited access to support strategies. Resilience emerges as a critical protective factor, enhanced by supportive environments. Conclusions: Health crises require a rapid response to manage immediate impacts and provide personalized follow-up for the psychological aftermath among healthcare professionals. Regular psychological support, cognitive-behavioral therapies, identification of the most vulnerable health workers and early intervention are the most effective approaches.
Introduction: Outpatient consultations in surgical settings are crucial for enhancing outcomes in the surgical field. This study aims to assess the quality of these consultations by analysing consultation length, conversation time, and eye contact in comparison to other medical consultaions. Patient satisfaction with the consultation time was also included as an additional dimension of quality assessment. Methods: This was a cross-sectional comparative study conducted in a Moroccan secondary-level hospital (Feb-Nov 2024). The participants were 42 physicians (21 surgeons, 21 medical specialists) and 191 surgical patients. The main outcomes were consultation duration, conversation time, eye contact, and surgical patient satisfaction (4-point Likert scale). The time variables were recorded in real time by a trained observer. Nonparametric tests were applied for group comparisons. Ethical approval was obtained, and written informed consent was secured from all participants. Results: The median consultation length was significantly shorter for surgical consultations (2.6 min) than for medical consultations (4.9 min), (*p* < 0.001; r = -0.670). The conversation time was also significantly shorter in surgery (*p* < 0.001; r = -0.516). Surgeons maintained eye contact for 54.26% (95% CI: 52.07% - 56.45%) of the conversations, whereas medical consultants maintained eye contact for 47.85% (95% CI: 45.42% - 50.28%) of the conversations. With respect to patient satisfaction, 33.5% (64/191) of surgical patients expressed dissatisfaction with the time allocated during their consultation. Conclusions: Surgical consultations were markedly shorter with less conversation time than medical specialties did; however, surgeons demonstrated greater visual engagement. Despite this behavioral adaptation, one-third of surgical patients reported time dissatisfaction, highlighting systemic challenges in meeting patient needs within severe time constraints.
Objective: To determine the mutational spectrum and microsatellite instability (MSI) status in colorectal cancer (CRC) patients in Morocco, and to examine associations between the clinical characteristics.Methodology: This prospective study was conducted on 55 patients diagnosed with colorectal adenocarcinoma at the National Institute of Oncology in Rabat. DNA was extracted from FFPE tumor tissues and sequenced using the OncomineTM Colorectal and Pancreatic Cancer Research Panel. Immunohistochemistry was performed to assess MSI status. Statistical analyses, including correlations between mutations and clinicopathological parameters, were conducted. Results: The study found that APC (45.5%), TP53 (43.6%), KRAS (21.8%), ARID1A (20%), PIK3CA (14.5%) and BRAF (12.7%) were the most common mutations. MSI-high status was found in 9.1% of patients, all of whom were <= 60 years old. Statistical analysis revealed a significant correlation between MSI-high status and age (p = 0.023), with no correlation found between mutations and other clinicopathological parameters. Conclusion: This study provides one of the first comprehensive insight into the mutational landscape of colorectal cancer (CRC) in Morocco, demonstrating a significant associations.The findings highlight the importance of next-generation sequencing (NGS) in guiding personalized treatment strategies for CRC and underscore the need to improve access to molecular diagnostics in Morocco.
Introduction: Aligned with the Sustainable Development Goals (SDG 3.2), Morocco has been working since 2018 to integrate the audit of neonatal deaths and stillbirths in hospitals into the Maternal Death Surveillance, Neonatal Audit, and Response System (MDSNARS), to reduce neonatal mortality to 7 per 1000 live births by 2030. However, the lack of accurate data on neonatal mortality hinders the planning and implementation of targeted strategies. Objective: The aim of this study is to identify and explain the multilevel determinants influencing the implementation of neonatal death audits, using the Consolidated Framework for Implementation Research (CFIR) framework, in order to inform system strengthening strategies. Methods: A descriptive and exploratory qualitative study was conducted in the Marrakech-Safi region. A total of twenty semi-structured interviews were conducted with stakeholders involved in MDSNARS at the national, regional, and local levels. The data were transcribed, translated into French, and analyzed using thematic content analysis. Results: Findings indicate that the implementation of neonatal audits remains partial. The main barriers identified include a shortage of qualified staff, a non-operational neonatal unit, and a negative perception of audits, often associated with a punitive approach. On the other hand, the scientific legitimacy of the audit, the quality of continuing education, and close support from the central level appear to be important motivators for teams in the field. Conclusion: Neonatal audit is a key lever for improving neonatal care. To optimize its effectiveness, it is imperative to strengthen motivating factors and remove barriers identified among healthcare providers and within hospitals.
Introduction: In Morocco, just like in all countries around the world, the aging population is becoming increasingly important. Our project was carried out with the aim of studying the influence of economic and socio-educational factors on the use of self-medication. Patients and Methods: Data were collected through different hospital departments regarding patients aged 65 and older. Various aspects were examined, including age, gender, education level, whether the patient lives alone or with their children, income stability, independence, acquisition of medications without a prescription, and potential complications. Results: Our sample included 356 patients; among them, 48.6% had received no formal education, and 82.6% obtained medications without a medical prescription or expert consultation, while 30.3% were hospitalized due to complications from these medications. 24.7% are aware of the potential risks associated with self-medication. Conclusion: It is crucial to intervene with this vulnerable elderly population, greatly influenced by economic and socio-educational factors, which exhibits a very high rate of self-medication and a lack of awareness regarding the potential increased occurrence of complications.
Background: Malnutrition is common in Crohn's disease, negatively impacting prognosis and contributing to various disease-related complications. The aim of our study was to assess the risk of malnutrition in these patients and to investigate its potential association with anthropometric parameters, clinical factors, and dietary restrictions. Materials and Methods: A cross-sectional study was conducted among patients with Crohn's disease at department "C" Gastroenterology Department of Ibn Sina Hospital from November 2024 to April 2025. All participants underwent a consultation that included a clinical interview, anthropometric measurements using bioelectrical impedance analysis, and scoring assessments. The Saskatchewan IBD-NR score was used to evaluate malnutrition risk. Collected data were compiled in an Excel database, and a statistical analysis was performed. Results: A total of 159 patients with Crohn's disease were included, with a mean age of 42.2 +/- 13.4 years and a male-to-female ratio of 0.59. Among them, 47.7% (74) were in an active disease phase, and 23.2% (44) were underweight. Dietary restrictions were reported by 104 patients (65.4%), while 38.7% (60) were found to have a high risk of malnutrition. A significant association was observed between a high risk of malnutrition and disease activity (p < 0.001), dietary restriction (p < 0.001), as well as FFMI (p = 0.048), FMI (p < 0.001), and BMI (p < 0.001). Conclusion: These findings highlight the significant relationship between disease activity, body composition, dietary practices, and the risk of malnutrition, emphasizing the need for comprehensive medical and nutritional management of patients with Crohn's disease.
Introduction: Maxillary canine impaction is a frequent clinical issue with significant esthetic and functional implications. Understanding its etiologies, diagnostic tools, and prognostic indicators is key for optimal treatment planning. Materials and Methods: A narrative review was conducted using PubMed (Medline), Web Of Science, Google Scholar, Cochrane Library, Scopus with keywords: "impacted canine," "prognosis," "surgical traction," and "orthodontic treatment." Only English and French articles were included, selected based on titles, abstracts, and fulltext relevance. Discussion: Prognostic factors include patient age, angulation, root development, and cooperation. Early diagnosis and intervention increase treatment success. CBCT imaging provides detailed assessment. Treatment options range from interceptive techniques to surgical-orthodontic approaches depending on prognosis. Conclusion: A better understanding of prognosis indicators guides clinicians toward tailored and effective treatment strategies.
Introduction: Acute colonic pseudo-obstruction (ACPO) or Ogilvie syndrome is a condition characterized by acute atonic dilation of the colon in the absence of mechanical obstruction. The underlying etiology for the development of ACPO is unclear. Short-acting cholinesterase inhibitor, neostigmine is frequently used for treating ACPO. Due to the possible deleterious adverse effect of neostigmine including cardiovascular suppression, it is usually administered under controlled settings in a critical care unit. Methylnaltrexone, a peripherally acting mu-opioid receptor agonist, is indicated for use in treating constipation secondary to systemic opioid use. In this study, we looked into the efficacy and safety of the use of subcutaneous methylnaltrexone in treating patients with ACPO. Materials & methods: This is a single-centered retrospective study assessing the efficacy and safety of utilizing subcutaneous methylnaltrexone in the treatment of ACPO. The search period was conducted over a period of 9 years. Radiological findings of large bowel ileus without obstruction was the search criterion for allocating ACPO patients. Exclusion criteria included mechanical large bowel obstruction, intervention by fluoroscopic decompression, and patients who received neostigmine but not subcutaneous methylnaltrexone. Patients received a standard dose of methylnaltrexone 12 mg every 24 hours until a bowel movement (BM) was achieved. Results: A total of 39 patients who received at least one dose of subcutaneous methylnaltrexone for the treatment of ACPO were identified. 97.44% of studied patients had received systemic opioids for pain control within 30 days prior to the diagnosis of ACPO. Twenty-two (56.4%) patients had pain improvement after receiving the drug. A total of 35/39 (89.74%) had a BM following methylnaltrexone administration (p-value= 0.01246). Among the responders, an average dose of1.17 doses (range of1-2) was administered to achieve the result. The average time of first BM occurrence after receiving methylnaltrexone was 12.85 hours +/- 12.29. Pain associated with ACPO measured by difference in pain scale 1-10/10, improved 5.47 hours +/- 7.43 following first dose of methylnaltrexone administration (p-value= 0.02265). No adverse events were reported in patients who received methylnaltrexone. Conclusion: In setting of reported increase in ACPO incidence worldwide, non-invasive and effective medical management with safe medication profile is called for. Our study delineated objective clinical resolution of symptoms and signs of ACPO through the use of subcutaneous methylnaltrexone with a significant safety profile. Further studies are required to better differentiate the overall efficacy of subcutaneous methylnaltrexone for treatment of ACPO overall and, more specifically, in setting of recent systemic opioid treatment.
Background: The benchmarking is a concept with multiple aims. The reflection on improving the governance of Basic Health Coverage (BHC) in Morocco leads us to analyze successful solutions that have been implemented in other countries. Objectives: This study aimed to make an international benchmark of BHC's governance models and look for good practices in other countries in order to study the possibility of their implementation at the Moroccan level. Methods: We benchmarked BHC's governance models by determining the criteria for selecting the benchmark countries. We have selected five countries, namely: Turkey, Malaysia, France, Chile, Rwanda. We analyzed governance models based on the five dimensions of the World Bank study "Governing Mandatory Health Insurance: Learning from Experience", which are: Coherence of the decision-making structure, stakeholder involvement, transparency and access to information, supervision and regulation, coherence and stability. Results: Our analysis based on the five dimensions showed that there are relative common factors with the governance model between the benchmark countries that allowed them to achieve universal health coverage, however, each country has introduced innovative rules and solutions adapted to its context and constraints. There are several good governance practices that we have drawn from this benchmark. Morocco can use these good practices to improve its governance model for BHC. An adaptation effort is necessary, taking into consideration the existing situation. Discussion: There is not a governance model suitable for all countries. Each country is trying to find a formula that will allow it to overcome its challenges. Morocco can draw inspiration from these models to instaure good practices to adopt, but this cannot happen without repositioning the governance of health coverage in the government's strategic vision in relation to the social protection agenda and the objectives of the health system. Conclusion: Improved governance has a direct impact on the performance of the basic health coverage system. In this sense, Morocco must take this aspect into consideration in the process of achieving universal health coverage as many other countries that have made this great step forward.
Introduction: Trisomy 21 is the most common chromosomal abnormality with a prevalence of 1/700 to 1/1000 live births. In Morocco, epidemiological data remains limited. This study aimed to describe the epidemiological and clinical profile of patients with trisomy 21 in the Rabat region over five years. Materials and Methods: This was a retrospective descriptive and analytic study of two complementary cohorts: one cohort of patients followed in outpatient consultation and one cohort of newborns diagnosed in the delivery room. Demographic, clinical data and comorbidities were analyzed using SPSS version 26.0. Results: The total population studied included 136 patients with 50.7% male newborns. Congenital hypothyroidism was the most frequent associated comorbidity (55.9%), followed by congenital heart disease (6.5%). Consultations paradoxically increased during the COVID-19 pandemic (33 in 2020, 105 in 2022). The mean maternal age in the neonatal cohort varied from 39.5 years in 2021 (100% >= 35 years) to 32.8 years in 2023. Conclusion: The high prevalence of congenital hypothyroidism and the low rate of documented heart disease suggest the need to adapt screening protocols to the Moroccan context. The impact of the COVID-19 pandemic revealed vulnerabilities in access to care, particularly for young mothers. Systematic screening for comorbidities and a multidisciplinary approach are essential to optimize care.
Introduction: Mirizzi syndrome is a rare complication of chronic vesicular lithiasis. It has been described as an obstruction of the common bile duct by a stone embedded in the vesicular neck or cystic duct, which through an associated inflammatory reaction totally or partially compresses the common bile duct leading to the formation of a cholecysto-biliary fistula. The aim of our work is to analyze the particular role of endoscopy in Mirizzi syndrome in our clinical practice. Patients & Methods: This is a retrospective descriptive study carried out in the Hepato-gastroenterology department of the University Hospital of Fez; we included all patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2013 and December 2022 with a confirmed diagnosis of Mirizzi syndrome (MS). Data were collected from ERCP registers. Results: A total of 35 MS patients were endoscopically managed between 2013 and 2022. Presenting symptoms were jaundice (60%), pain (20%) and cholangitis (62%). ERCP established diagnosis in 100 % cases. Beltran Type I was the most common type presentation (77%). All patients underwent endoscopic sphincterotomy and stone extraction was performed in 25 patients. A total of 26 patients underwent surgery with good outcome. Total cholecystectomy was performed in 18 cases, subtotal cholecystectomy in 6 cases and choledocotomy combined with biliary-digestive anastomosis was performed in 2 cases. The overall post-operative mortality rate was 2.8%. Conclusion: This study confirmed the place of ERCP in the diagnosis and treatment of Mirizzi syndrome.
Postnatal depression is a mood disorder that steals the joy of motherhood. it affects both of the mother and her child. The diversity of risk factors complicates the prevention. Several studies have shown a significant decrease in its incidence thanks to continuous support during pregnancy, labor and postpartum. Women who have benefited from this care have reported optimal control of labor, aAbetter mother-child bond, and a positive perinatal experience; the protective effect of perinatal support seems evident. The objective of this literature review is to describe the aspects of postnatal depression, the methods of perinatal support, and its impact on perinatal mental health. The access to Doulas and educating medical and paramedical staff should be a priority in perinatal healthcare.
Background: Patients with incidental benign solitary papilloma of the breast with imaging concordance may be offered follow-up treatment. Recently, as vacuum-assisted breast biopsy (VAB) has become more common, it is increasingly being used as an alternative to core needle biopsy for initial biopsy. This study investigated the factors that necessitate surgical excision after initial needle biopsy of papillary breast lesions. Methods: A retrospective review was conducted of patients diagnosed with papilloma or papillary findings in pathology reports at a single institution between 2001 and 2020. Logistic regression and Cox proportional hazards models were used to analyze the factors associated with surgical excision and papilloma recurrence. Results: Among the 266 patients reviewed, the malignancy upgrade rate was 6.7%, with significantly higher rates in lesions with atypia (p<0.001). Factors associated with the need for surgical excision after initial needle biopsy included older age (odds ratio [OR] =1.064; p=0.015), larger tumor size (OR=3.015; p=0.003), and absence of intraductal lesions (OR=0.049; p<0.001). Additionally, a higher body mass index (BMI) was associated with the recurrence of benign papillary lesions (OR=1.156; p=0.045), and patients with a BMI below 25 showed a significantly lower recurrence rate. Conclusion: Older age, absence of intraductal lesions, and larger tumor size were associated with the likelihood of requiring surgical excision following needle biopsy. These findings suggest that VAB or vacuum-assisted excision should be considered in younger women with smaller intraductal lesions. Additionally, higher BMI was found to be significantly associated with the recurrence of benign papillomas.
Background: Smoking is one of the main preventable risk factors for non-communicable diseases (NCD). Objective: The objective of this study was to estimate the prevalence of smoking and identify the associated socioeconomic and demographic determinants in the adult (18+) population of Sal & eacute;, Morocco. Methods: A cross-sectional study was conducted in February 2021 using a two-stage stratified probability sampling design. Based on a questionnaire, we collected information on tobacco use and some socioeconomic and demographic variables. Results: The prevalence of smoking among adults (both genders) was 23.3% (23.0% in urban and 26.3% in rural). The proportion of smokers was largely higher among men (47.5%) compared to women (1.1%). Additionally, smoking was found to be significantly associated with age, household wealth index, educational level, marital status, occupation, average monthly household income, being the head of household, and having access to improved sanitation facilities (both sexes combined). Conclusion: Smoking is a real public health problem in Sal & eacute;. This requires a comprehensive approach and commitment from all stakeholders to reduce smoking-related mortality and morbidity. Prevention, awareness and social inclusion remain the best methods to reduce the prevalence of smoking.
Introduction: Osteoma is a rare benign osteogenic tumor characterized by the proliferation of slow-growing compact and spongy bone, most commonly occurring in the craniofacial skeleton, and rarely affecting the jaws. Case report: A young 18-year-old patient consulted for discreet pain in the right retromolar region and progressive mandibular swelling. The panoramic radiograph showed a well-defined radiopaque image, approximately 3 cm in diameter, extending from the 47 to the anterior edge of the ascending branch. Additional sectional imaging was requested to assess the extension of the lesion in the anteroposterior direction and its relationship with the mandibular canal, and 47 and 48. Treatment consisted of resection of the lesion. After the pathology examination, the definitive diagnosis was in favor of an osteoma. Conclusion: Osteoma is a benign bone tumor, observed most frequently in young adults. Its clinical and radiological characteristics must be well known in order to differentiate it from other benign maxillary tumors and to establish the appropriate treatment.
Introduction: Governance is a polysemic concept whose application in the field of health coverage has specific characteristics. The objective of our work is to search for a reference for evaluating the governance of the Basic Health Coverage system (CMB) and to transpose it to the Moroccan model in order to propose ways of improvement. Methods: We used the bibliographical research to elaborate the literature review, the World Bank's reference frame and the semi-directive interview for the evaluation of the governance model of the CMB system in Morocco. Results: There is a single standard for assessing CMB governance developed by the World Bank in 2008 in five main dimensions, namely: Decision-making structure, stakeholder involvement, transparency and access to information, supervision and regulation, and finally consistency and stability. The evaluation of the Moroccan model showed that there has been progress in the governance of the CMB system for decades. However, the model has several dysfunctions that hinder its basic principles. Conclusion: our proposals for improvement, resulting from the evaluation of the Moroccan model, present concrete ideas to improve the governance of the CMB system that will systematically impact its performance and strengthen citizen confidence in the performance and sustainability of the services offered.
Introduction: The Covid-19 pandemic crisis was an unexpected exceptional situation that prevented the closure of school premises. In order to cope and ensure the continuation of courses, education officials and administrators were called upon to invest effectively in the implementation of measures for the purposes of distance education and training by providing information and communication technology resources. Materials and methods: To achieve our objective, we carried out two simultaneous surveys carried out through two questionnaires administered via Google Forms, to the students and the teachers of the Faculty of Educational Sciences of Rabat in Morocco. Results: 73.34% of students were satisfied, 10.66% of the students preferred face-to-face and thought that distance learning cannot replace face-to-face teaching and 16% opted for mixed education. 58.34% of the teachers were satisfied with the situation of distance learning, 20.83% preferred face-to-face and 20.83% were open for the two teaching modes. Conclusion: Distance learning has proven to be one of the most effective solutions to meet the needs of learners during such health emergencies crises.
Introduction: Hypophosphatemic rickets is a rare hereditary disorder of phosphorus metabolism, whose prevalence is still unknown, marked by the resistance to vitamin D therapy. Case report: This article reports the case of a 3-year-old boy diagnosed with this condition and focuses on his oral manifestations and the challenges encountered in treating them. The general symptoms reported included stunted growth, irritability, agitation, craniotabes, prominence of the frontal bones, and bowing of the legs. Orofacial and dental manifestations included enlarged pulp chambers, dental abscess in teeth 51 and 61, alveolar bone loss and diminished lamina dura. Dental prophylaxis program was set up and extraction of affected teeth was performed under local anesthesia. Comment: Pediatric dentists should remain vigilant for these symptoms as they can be among the earliest indicators of the disease and contribute to an early diagnosis, thus facilitating rapid management within an interdisciplinary team. When taking care for children with vitamin-D-resistant rickets, dental professionals must pay particular attention to the establishment of a trust-based relationship with the patient due to their tendency to be irritable, the patient's education and dental prophylaxis and the provision of radical dental care following the complications encountered, given the poor prognosis of affected teeth. Conclusion: this case report outlines the dental and maxillofacial manifestations of a 3-year-old boy diagnosed with hypophosphatemic rickets.
Introduction: Cardiac arrest is one of the most serious circumstances needing quick response. Nurses are the first to arrive at the patient's bedside in the event of cardiac arrest, starting cardiopulmonary resuscitation (CPR).As a method of teaching CPR, high-fidelity simulation has been demonstrated to have a substantial impact.Thus, the present study aims to evaluate the impact of adult CPR training based on high-fidelity simulation on anxiety and evolution in self-efficacy, satisfaction and self-confidence of undergraduate nursing students at the Higher Institute of Nursing Professions and Health Techniques in Fez, Morocco. Methods: An intervention study with a simulation group and a control group was carried out with 49 student nurses. The simulation group (n=25) received traditional training (theoretical lecture and procedural demonstration) and simulation-based CPR training, while the control group (n=24) received only traditional training. Data were obtained using the State-Trait Anxiety Inventory (STAI-Y1 and STAI-Y2), the Self-Efficacy Scale and the Student Learning Satisfaction and Confidence Scale. Results: Post-test results of the STAI-Y1 scale revealed a significant reduction in situational anxiety in the simulation group, with a mean score of 30.84 +/- 1.84 out of 80, compared with the control group score (43.04 +/- 1.36). Assessment of post-simulation self-efficacy showed a significant advantage for the simulation group (35.28 +/- 2.47) out of 40 over the control group (20.96 +/- 1.36). Mean CPR self-efficacy retention scores 30 days after training were significantly higher for the simulation group (34.80 +/- 2.19) than for the control group (20.88 +/- 1.36). Nevertheless, a significant decrease in mean self-efficacy scores was recorded for the simulation group between the post-test immediately after simulation training (35.28 +/- 2.47) and the post-test 30 days after training (34.80 +/- 2.19). Thus, the results revealed that mean satisfaction (23.16 +/- 0.68 out of 25) and self-confidence (36.08 +/- 0.99 out of 40) scale scores were high immediately after the simulation experience in the simulation group. Nevertheless, a significant increase in satisfaction (24.08 +/- 0.99) and a significant decrease (33.72 +/- 1.59) in self-confidence were recorded 30 days after simulation training. Conclusion: The outcomes demonstrated that adult CPR training using high-fidelity simulation was superior to the conventional approach in terms of decreasing anxiety and enhancing and maintaining undergraduate nursing students' self-efficacy, satisfaction, and confidence.
Introduction: Postpartum haemorrhage (PPH) remains the leading cause of maternal mortality, with placental abruption (PA) being a serious and challenging etiology. Late diagnosis and inadequate management of PA can exacerbate PPH and worsen maternal outcomes. This work aims to analyse the epidemiological, clinical and Paraclinical profile of PA in the Intensive Care Unit (ICU); as well as to determine the profile of coagulopathy in PPH and to discuss various treatment modalities. Materials and Methods: This retrospective, descriptive, nonJanuary 2019 to December 2023. Results: Forty-two patients met the inclusion criteria, with a mean age of 32 years. Primiparae constituted 33.4% of the cohort. 78.6% lacked prenatal care. The average gestational age was 32 weeks. Preeclampsia was the predominant risk factor (57.1%). Symptoms included mostly slow fetal movements, hemorrhage, and abdominal rigidity. At admission, 26% of patients exhibited hemorrhagic shock. General anesthesia was used in 82.5% of cases. In the operating room, 12% of patients received fibrinogen, and 50% received tranexamic acid. Blood transfusions were administered to 67% of patients, with an average of 2.14 packed red blood cells (PRBCs), 5.3 platelets (PLTs), and 3.5 fresh frozen plasma (FFP). Surgical interventions included hysterectomy, B-Lynch procedure, and vascular ligature. The mean duration of mechanical ventilation in the ICU was 3.66 days. The maternal mortality rate was 9.5%, and five newborns survived to discharge. Conclusion: This study emphasizes the need for a multidisciplinary approach and early intervention to manage PPH from PA effectively, and highlights the importance of national programs to address modifiable risk factors.
