Retained placenta continues to be fatal but frequency can be reduced

Abstract

Retained placenta is potentially lift-threatening not only because of retention per se, but because of associated haemorrhage and infection as well as complications related to its removal. These risks are increased in women in poor social circumstances due to pre-existing malnutrition, anaemia and unsupervised home deliveries. The present study was undertaken to assess the situation in this rural area. A previous study at the same place suggested preventive strategies an and individualised approach. 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% (two of 23,838 vaginal deliveries). Sixty-five women were admitted with retained placenta after home deliveries and three after delivery at other hospitals The age of most of the patients was between 20 and 29 years and most were para 2 or 3. In twenty-three (32.4%) cases, women had delivered preterm. Twelve (16.9%) women had previous uterine surgery and 10 (14.1%) had had a retained placenta in the past. Twenty-six (36.61%) women had come in a state of severe shock. Thirty-six (50.7%) women required general anaesthesia for manual removal. One woman with an adherent placenta had to undergo hysterectomy (1.40%). The maternal mortality was 5.6%. Perinatal loss was 7.04%. It is unfortunate that of the four deaths, two women had actually delivered at a near by district hospital and were referred moribund and died. A properly conducted delivery can reduce the incidence of retained placenta and if retention occurs, timely appropriate treatment can save life.

Risk factors for maternal mortality in Delhi slums: A community-based case-control study

“…These risks are increased in women in poor social circumstances due to preexisting malnutrition, anemia and unsupervised home deliveries. [14] Among the indirect causes, anemia was found to be the major cause of maternal death in the present study. Our Þ ndings are consistent with those of other researchers who have reported that direct causes together with anemia are responsible for more than 65% of all maternal deaths in developing countries.…”

Effect of Oxytocin Injection into Umbilical Vein for Management of Retained Placenta

“…In a study by Chhabra et al 10 in Kasturba Hospital, Delhi, it was found that incidence of retained placenta was 0.23% of all births over 15 years. In their study, out of four deaths two women delivered at nearby district hospital and were referred moribund and died.…”

Early Pregnancy Microalbuminuria as a Predictor of Pre-Eclampsia

“…Shaarawy et al who have evaluated the clinical value of microtransfferrinuria and microalbuminuria in prediction of preeclampsia in asymptomatic women have concluded that microtransfferrinuria was a more sensitive marker than microalbuminuria [33]. However, Chhabra et al have found that estimation of microalbuminuria around 18 weeks of gestation seemed useful, especially in primigravida [34,35].…”