Retained placenta continues to be fatal but frequency can be reduced
Chhabra, S.; Dhorey, M.
Journal of Obstetrics and Gynaecology the Journal of the Institute of Obstetrics and Gynaecology 22(6): 630-633
2003
ISSN/ISBN: 0144-3615 PMID: 12554250 DOI: 10.1080/0144361021000020402Document Number: 260965
A study was conducted in the Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Maharashtra, India, to assess the frequency of retained placenta in this rural area over 15 years (1986-2000). Results revealed that the incidence of retained placenta has been 0.23% of all births over 15 years. Of the deliveries at Kasturba Hospital, the incidence of retained placenta was 0.008% (2 of 23 838 vaginal deliveries). 65 women were admitted with retained placenta after home deliveries and 3 after delivery at other hospitals. The age of most of the patients with retained placenta was between 20 and 29 years and most were para 2 or 3. In 23 (32.4%) cases, women had delivered preterm. 12 (16.9%) women had previous uterine surgery and 10 (14.1%) had a retained placenta in the past. 26 (36.61%) women had come in a state of severe shock. 36 (50.7%) women required general anaesthesia for manual removal. One woman with an adherent placenta had to undergo hysterectomy (1.40%). Maternal mortality was 5.6% and perinatal loss was 7.04%. Of the 4 deaths, 2 women had actually delivered at a nearby district hospital and were referred moribund and died. It is suggested that a properly conducted delivery can reduce the incidence of retained placenta, and if retention occurs, timely appropriate treatment can save life.