title: The effect of placental removal method on perioperative hemorrhage at cesarean delivery; a randomized clinical trial.
abstract: OBJECTIVE
  The aim of this prospective randomized clinical study is to compare whether the removal methods of placenta during cesarean section have an impact on perioperative hemorrhage.
  
  
  METHODS
  One hundred women with singleton term pregnancies undergoing elective cesarean section through lower segment transverse incision under general anesthesia were included in this study. They were randomly allocated to two groups according to the type of removal of the placenta from the uterus after childbirth; manually or spontaneously. The main outcome measures were change in hemoglobin levels after cesarean section. The secondary outcomes were operative time, required transfusions and postcesarean endometritis.
  
  
  RESULTS
  Fifty patients were randomized to the manual removal group and 50 to the spontaneous group. The demographic characteristics of the two groups were similar. There were no difference in terms of change in hemoglobin levels after cesarean section between two groups (1.6 ± 1.0 and 1.5 ± 1.0, respectively; P = 0.711). In addition, none of the patients required blood transfusion and showed postpartum infections.
  
  
  CONCLUSIONS
  There is not an association between the method of removal of the placenta and postpartum blood loss in cesarean section deliveries.
authors: Department of Obstetrics and Gynecology, GATA Haydarpasa Training Hospital, Istanbul, Turkey. drsmetgun@yahoo.com
authors: Ismet
authors: I
authors: Gün
authors: Ozkan
authors: O
authors: Ozdamar
authors: Serkan
authors: S
authors: Ertuğrul
authors: Oznur
authors: O
authors: Oner
authors: Vedat
authors: V
authors: Atay
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D010920:Placenta; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000378:metabolism; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins