Risk of retained placenta: Multivariate approach

Abstract

These findings could be used to develop a predictive procedure for identifying high-risk cases of retained placenta.

The retained placenta: Historical and geographical rate variations

“…Here, the rate of manual removal California (Combs and Laros 1991) 1978-1988 Active management Michigan (Dombrowski et al 1995(Dombrowski et al ) 1984(Dombrowski et al -2002 Active management North Carolina (Jackson et al 2001) 1998-2000 1,486 2.00 Oxytocin before or after placental delivery (combined data) London (El-Refaey et al 2000) 1996-1998 1,000 2.70 2.60 Syntometrine, syntocinon or ergometrine or oral misoprostol (combined data) Scotland (Hall et al 1985) 1967-1981 36,312 2.24 Management of third stage not stated Perth (Magann et al 2005b(Magann et al ) 1998(Magann et al -2002 Combined data for PPH and no PPH. Management of third stage not stated South Australia (Khong 1998(Khong ) 1986(Khong -1995 Management of third stage not stated Adelaide (Khong 1998) 1993-1995 7,882 2.00 Management of third stage not stated Australia (Titiz et al 2001) 1992-1999 3,734 3.72 Some had ergometrine Norway (Tandberg et al 1999) 1990-1994 24,750 0.60 Active management Sweden (Hammar et al 1990 (Onwudiegwu and Makinde 1999) 1990-1996 6,511 0.37 Active management Zaria, Nigeria (Harrison 1985) Unknown 12,805 0.40 Management of third stage not stated Saudi Arabia (Soltan and Khashoggi 1997) 1990-1995 0.55 Management of third stage not stated Saudi Arabia (Adelusi et al 1997(Adelusi et al ) 1990(Adelusi et al -1995 Management of third stage not stated Shanghai (Zhou et al 1999(Zhou et al ) 1993(Zhou et al -1998 Combined data for previous TOP and no TOP, routine ergometrine for third stage Hong Kong (Ng et al 2001(Ng et al ) 1998(Ng et al -1999 (5.42%) is higher than the rate of RP at 30 min (3.29%), indicating that manual removal of the placenta in that particular centre was often performed before 30 min. However, this study also provides evidence from studies that define RP by the length of the third stage of labour and these show differences between high...…”

“…Possible contributing factors include differences in genes, climate, parity or age of parturients, definition of RP or access to services. Previous uterine surgery (Panpaprai and Boriboonhirunsarn 2007;Soltan and Khashoggi 1997;Zhou et al 1999), pre-term delivery (Combs and Laros 1991;Soltan and Khashoggi 1997) and augmented or induced labour (Adelusi et al 1997;Combs and Laros 1991;Magann et al 2005a) have also been implicated and may play an important role in explaining the discrepancy in rates of RP. We therefore sought to explore rates of RP in different regions around the world through a systematic review of international studies.…”

The number of multinucleated trophoblastic giant cells in the basal decidua is decreased in retained placenta

“…Placenta accreta, as demonstrated by (partial) absence of basal decidua,7 8 9 is associated with damage caused by prior uterine surgery, including caesarean section and curettage, placenta praevia and advanced maternal age 5 6. Such associations are not clear for PA 10 11 12…”

Socio-Demogrphic Profile and Complications of Patients with Retained Placenta in a Tertiary Centre, South-South Nigeria

“…An incidence of 0.8% was reported in Jos North-Central Nigeria [18], while a relatively lower incidence of 0.6% was reported in Saudi Arabia [8]. This slight difference may be due to the difference in the number of unbooked pregnant women who delivered outside the hospital unsupervised and subsequently present to the hospital with complications of retained placenta.…”

“…Similarly, high figures of 76.9%, 71.2% and 89.1% were recorded for the same age range of 21 -35 years in Thailand [15], Saudi Arabia [8] and Nigeria [16] respectively. This relationship to age may be a reflection of the reproductive age group of the study population [19].…”