Alphocine Adhiambo O., 21

Alphocine is the first-born child in her family. She lives with her single mother and three siblings in a two-room semi-permanent house. Alphocine completed high school but was unable to proceed to tertiary education due to lack of school fees. She is currently unemployed and depends entirely on her mother, who survives on menial jobs to support the family. Alphocine reported experiencing persistent morning lethargy and missed menstrual periods, prompting her to seek medical evaluation, where pregnancy was confirmed. She informed her mother, who encouraged her to begin antenatal care. Alphocine attended four ANC visits, each requiring her to walk for over an hour to reach the clinic. On the day of the incident, she was initially well and even prepared breakfast. However, shortly afterward, she suddenly developed heavy vaginal bleeding. Her mother alerted a community health promoter, but as the bleeding became profuse and uncontrollable, they flagged down a motorbike that rushed her to Siaya County Referral Hospital. Upon arrival at the hospital, Alphocine was in a critical condition—she was extremely pale, severely dizzy, weak, and barely able to sit or stand. She showed signs of acute blood loss and was visibly distressed. An urgent assessment was conducted, and she was quickly diagnosed with placental abruption and extraplacental haematoma, a life-threatening obstetric emergency requiring immediate medical intervention. An extraplacental haematoma is a collection of blood that forms outside the placenta but within the uterus during pregnancy. It occurs when blood vessels between the uterus and the placenta rupture, causing blood to accumulate in the uterine tissues rather than flowing out. Placenta abruptio and extraplacental haematoma are dangerous because they both interfere with the placenta’s ability to supply oxygen and nutrients to the unborn baby (fetus) and may also lead to significant blood loss in the mother. Without oxygen, the fetal organs cannot function properly, which can quickly lead to fetal distress and intrauterine fetal death. While at the hospital, Alphocine learned about Helpster Charity through the hospital social worker as she expressed concern about her inability to meet the medical costs. A formal social assessment was conducted, which confirmed that she was genuinely underprivileged and unable to afford the required treatment.

Alphocine was brought to the hospital with abdominal pains and bleeding. She was taken for an emergency surgery where the uterus was accessed,the placenta was extracted , B- lynch compression suture placed. The abdomen was closed and dressed . Unfortunately the infant had passed on. She was admitted for post surgery monitoring where she was administred IV Tramadol, brufen, paracetamol among other medication. She responded well to medication and was eventually discharged on orals. A visit to her revealed that her wound was healing well and she could even do house chores.

Medically, Alphocine’s prognosis is good following prompt diagnosis and appropriate management of placental abruption. With adequate treatment, monitoring, and post-event care, she is expected to recover physically without long-term complications. However, the intrauterine fetal demise (IUFD) represents a profound emotional and psychological loss. With proper postnatal follow-up, counseling, and psychosocial support, Alphocine can gradually cope with the loss and regain emotional stability. Future pregnancies can still be possible, and with early antenatal care and close monitoring, the risk of recurrence can be significantly reduced.