Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

Urner, Fiona; Zimmermann, Roland; Krafft, Alexander

doi:10.1155/2014/274651

Cited by 33 publications

(27 citation statements)

References 26 publications

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“…An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity [6].…”

Section: Discussionmentioning

confidence: 99%

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Postpartum Hysterectomy a Case Report of a Saving Life Surgery

Cunha¹,

Soeiro²,

Teixeira³

et al. 2016

JGO

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Postpartum hemorrhage (PPH) is the most cause of maternal mortality all over the world important. Its prevalence is about 4 cases in 10,000 deliveries. However, the risk of maternal death is nearly 16% of all maternal deaths in developing countries, especially in Africa. It depends on the resources to stop bleeding, medical and surgical. The first ones are uterotonics medication (prostaglandin, methylergonovine and oxytocin), and the latest professional apt to perform surgical procedures, such as B-Lynch surgery and the peripartum hysterectomy. A woman, 20 years old, GI, P0, A0, with a single pregnancy, 42 weeks of gestational age and 5 prenatal bookings was attended at the emergency on April 12 th 2015. The next day the patient delivered a male baby. The uterus was soft and at the examination she expelled a great amount of clots. She was prescribed Ringer lactate 500 ml + oxytocin 15 IU + methylergonovine 0.2 mg IM + misoprostol 800 µg per rectum. She continued bleeding and a hysterectomy was performed. The patient was discharge in good condition. The pathology revealed myometrium permeated by trophoblasts (placenta accreta).

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“…An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity [6].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless the use of ultrasound and Doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity [6].…”

Section: Discussionmentioning

confidence: 99%

Postpartum Hysterectomy a Case Report of a Saving Life Surgery

Cunha¹,

Soeiro²,

Teixeira³

et al. 2016

JGO

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“…Following this, it was believed that timely MROP after delivery may reduce maternal morbidity. However, there is little evidence to support the notion that MROP should be performed when the placenta has not been delivered after delivery . In addition, MROP sometimes causes severe post‐partum hemorrhage .…”

Section: Introductionmentioning

confidence: 99%

Manual removal of placenta in women having unpredictable adherent placenta

Furukawa

Fujisaki

Maki

et al. 2018

J of Obstet and Gynaecol

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“…Placenta adherens, incarcerated placenta and placenta accreta are the common causes of retained placenta [8]. Placenta increta is an abnormal placental implantation in which placenta villi invade into the myometrium, while in placenta percreta, placental villi penetrate through the uterine serosa or adjacent organ, usually the urinary bladder [9,10].…”

Section: Introductionmentioning

confidence: 99%

A large amniocele through a fundal uterine defect diagnosed on 2D ultrasound imaging

Aiyekomogbon¹,

Ojah²,

Shinkafi³

et al. 2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. ABSTRACTIntroduction: Amniocele is herniation of amniotic sac through a uterine myometrial defect. It commonly results from intrauterine procedures such as suction evacuation, dilatation and curettage, manual removal of placenta and other products of conception, etc. Early diagnosis is imperative as that will go a long way to reduce morbidity and mortality. Case Report: A 35-year-old G4P3+0 women was presented to our health facility at 21st week gestation with a week history of lower abdominal pain. Obstetric ultrasound scan done at presentation revealed a fundal myometrial defect with a large amniocele through it, resulting in apparent oligohydramnios. Her first two deliveries were uneventful, but the third was complicated by post-partum hemorrhage due to retained placenta. This necessitated instrumentation and manual removal in the theatre at a secondary Health institution, four years prior to the index pregnancy. No immediate complication was noticed after the procedure. Two weeks after this diagnosis, precisely at 23rd week gestation, she had laparotomy, aimed at reducing the herniated amniotic sac and repairing the defect. This was not possible due to the narrow neck of the defect. She was then closed back and kept on exclusive bed rest and weekly sonographic evaluation of the pregnancy. A scan done at 31st week gestation revealed ruptured herniated amniotic sac into the peritoneal cavity with fetal distress. Estimated ultrasound fetal weight at this time was 1.76 kg. She had emergency cesarean section with delivery of a live very low birth weight baby whose APGAR score was 7 and 8 at 1 and 5 minutes respectively. The baby was admitted into special care baby unit (SCBU) but died 10 hours thereafter. The myometrial defect and uterine incision were repaired in layers. She did well, hemodynamically stable and was discharged on postoperative day-7. Follow-up visits were satisfactory. Conclusion:This case is presented to emphasize the need for training and retraining of physicians and midwives on active management of third stage of labor to forestall the observed pitfalls. It also brings to the fore the utility of gray scale and color Doppler ultrasound in antenatal diagnosis of uterine defect and placenta accreta.

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Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

Cited by 33 publications

References 26 publications

Postpartum Hysterectomy a Case Report of a Saving Life Surgery

Postpartum Hysterectomy a Case Report of a Saving Life Surgery

Manual removal of placenta in women having unpredictable adherent placenta

A large amniocele through a fundal uterine defect diagnosed on 2D ultrasound imaging

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