Manual removal of the placenta--a case control study.
The aim of this study was to determine the incidence and complications related to manual removal of the placenta in a regional hospital in Australia. The study was carried out at the Goulburn Valley Base Hospital in Shepparton. The hospital medical records were reviewed from 1992 to 1999. A total of 3734 singleton live vaginal deliveries took place during the 7-year study period. The placenta was removed manually in 114 women (3%). For a control group, a series of 113 women who had singleton live vaginal deliveries from the same period were chosen at random. The case and control groups were similar in age, parity, and gravidity. A previous history of retained placenta and a history of preterm delivery in the current pregnancy were significantly related to retained placenta (OR 9.8 [95% CI 1.1-85.5] and OR 5.6 [95% CI 1.1-26.8], respectively). The cases received significantly more blood transfusions than the control group (13% versus 0%). Decreased maternal age was also significantly related to retained placenta. There were also more post-delivery dilatation and curettage (D&C) operations and diagnosis of endomyometritis in the case group. However, these differences were not statistically significant. One woman, in the case group, had to have a hysterectomy due to placenta accreta.
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Goulburn Valley Base Hospital, Shepparton, Victoria, Australia.
Wallace
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Voaklander
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D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D004107:Dilatation and Curettage / Q000706:statistics & numerical data; D004716:Endometritis / Q000150:complications; D005260:Female; D020073:Gravidity; D006801:Humans; D015994:Incidence; D008423:Maternal Age; D007752:Obstetric Labor, Premature / Q000150:complications; D010298:Parity; D018457:Placenta, Retained / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D011247:Pregnancy; D012008:Recurrence; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology