Hasan Titiz FRANZCOG Staff Specialist Obstetrics and Gynaecology, Allan Wallace MB BS Resident Medical Officer Obstetrics and Gynaecology, Donald C Voaklander PhD Senior Lecturer Epidemiology
Manual removal of the placenta - a case control study
Article first published online: 13 FEB 2008
Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 41, Issue 1, pages 41–44, February 2001
How to Cite
Titiz, H., Wallace, A. and Voaklander, D. C. (2001), Manual removal of the placenta - a case control study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 41: 41–44. doi: 10.1111/j.1479-828X.2001.tb01292.x
- Issue published online: 13 FEB 2008
- Article first published online: 13 FEB 2008
The aim of this study was to determine the incidence and complications related to manual removal of the placenta in a regional hospital in Australia. The study was carried out at the Goulburn Valley Base Hospital in Shepparton. The hospital medical records were reviewed from 1992 to 1999. A total of 3734 singleton live vaginal deliveries took place during the 7-year study period. The placenta was removed manually in 114 women (3%). For a control group, a series of 113 women who had singleton live vaginal deliveries from the same period were chosen at random. The case and control groups were similar in age, parity, and gravidity.
A previous history of retained placenta and a history of preterm delivery in the current pregnancy were significantly related to retained placenta (OR 9.8 [95% CI 1.1–85.5] and OR 5.6 [95% CI 1.1–26.8], respectively). The cases received significantly more blood transfusions than the control group (13% versus 0%). Decreased maternal age was also significantly related to retained placenta. There were also more post-delivery dilatation and curettage (D&C) operations and diagnosis of endomyometritis in the case group. However, these differences were not statistically significant. One woman, in the case group, had to have a hysterectomy due to placenta accreta.