Retained placenta--a major cause of maternal morbidity

Retained placenta is a condition when placenta is not delivered by 30 minutes after delivery of baby. It commonly occurs among those women who deliver at home and it is responsible for more of maternal morbidity and mortality. One reason behind this is it mostly occurs in home delivery where active management of third stage of labour is lacking and once it takes place it increases the chances of post partum haemorrhage (PPH) and sepsis irrespective of place of delivery. In this prospective study carried out in a Hospital which is located at a distance of 10-12 kilometers from the centre of the capital, we tried to find out the prevalence of retained placenta, its relation with the place of delivery, steps taken to manage the cases of retained placenta and morbidity in terms of blood loss and hospital stay. The frequency of retained placenta in this study is 3.96% with majority having home delivery (82.8%). Those women who had blood loss of more than 1 litre (4.0%) all were home deliveries. Among all 12.0% cases had severe anaemia and needed significant amount of blood transfusion. All cases with retained placenta were first tried with use of oxytocics and controlled cord traction followed by manual removal of placenta under general anaesthesia. All cases were successfully managed with control cord traction (CCT) except 18 cases who needed manual removal of placenta (MRP).