Retained placenta still a continuing cause of maternal morbidity and mortality

To determine the frequency, causes and outcome of patients with retained placenta.

Descriptive case series. This study was carried out at Liaquat University Hospital, Gynae Unit-I, from January 2005 to December 2007. Two years retrospective and one year prospective analysis of patients was done according to age, parity, causes, place of delivery, person who conducted the delivery, conservative and surgical procedures, maternal morbidity and mortality. Patients were examined and appropriate investigations were done. The patients who came with or developed retained placenta at Liaquat University Hospital were included in the study. The patients having retained placenta due to uterine abnormalities were excluded from the study. All the information was collected on a predesigned proforma and analyzed on SPSS version 10.0.

About 8782 patients were admitted during the specified period. Ninety patients had retained placenta. Frequency of retained placenta was 37.7% in women of age group 26 to 30 years, 26.6% upto age of 35 years, 22.2% in age 20-25 years, it was low between 36-40 years of age, while the frequency was high in women of low parity (44.4%). Causes included augmentation by oxytocics in 38.8%, manipulation 38.8%, inertia 14.4% and tumour (fibroid) 7.7%. Majority of patients (60%) had a home delivery. Delivery by Dai was done in 72.2%. The commonest complication was anaemia 48.8%, followed by puerperal pyrexia 24.4%, hypovolaemic shock 22.2%, acute renal failure 3.3% and hepatic failure in 1.1% respectively.

Retained placenta is a frequent cause of maternal morbidity in Pakistan.