Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery

Hirokazu Naoi; Keiichi Kumasawa; Hitomi Nakamura; Aiko Nishikawa; Tadashi Kimura; Kazuhide Ogita

doi:doi:10.11648/j.jgo.20160402.11

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Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery

Hirokazu Naoi, Keiichi Kumasawa, Hitomi Nakamura, Aiko Nishikawa, Tadashi Kimura, Kazuhide Ogita

Published in Journal of Gynecology and Obstetrics (Volume 4, Issue 2)

Received: 2 March 2016 Accepted: 28 March 2016 Published: 13 April 2016

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Abstract

A retained placenta after delivery can lead to bleeding and infection or other serious complications. There are 2 approaches for managing this condition: one is observation until spontaneous expulsion or resorption of the placenta, the other is active intervention such as manual removal, dilation and evacuation, uterine artery embolization, and hysterectomy. In this study, we investigated cases of retained placenta in our institution. We reviewed cases of retained placenta treated in our institution to investigate the associated risk factors and provide indications for its clinical management. 28 patients with retained placenta were treated in our institution from April 1, 2008 to March 31, 2012. Clinical background, management, and prognosis were retrospectively reviewed. Induced or augmented labor, primipara, pregnancy after reproductive technology and post-term delivery after 41 weeks were found to be risk factors for retained placenta in this study. Patients with severe complications showed a significantly larger maximum diameter of the retained placenta than those without serious complications. Patients showing partial retention of the placenta with a maximum diameter < 3 cm are at a reduced risk of serious complications and should be managed by observation.

Published in	Journal of Gynecology and Obstetrics (Volume 4, Issue 2)
DOI	10.11648/j.jgo.20160402.11
Page(s)	7-11
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Retained Placenta, Postpartum Hemorrhage, Intrauterine Infection

References

[1]	Deneux-Tharaux C, Macfarlane A, Winter C, et al “Policies for manual removal of placenta at vaginal delivery: variations in timing within Europe.’’ BJOG, Vol 116, pp 119-124, Jan 2009
[2]	Akol AD, Weeks AD. “Retained Placenta: will medical treatment ever be possible?’’ Acta Obstet Gynecol Scand. Jan 2016 Epub ahead of print
[3]	Coviello EM, Grantz KL, Huang CC, et al. “Risk factors for retained placenta.’’ Am J Obstet Gynecol. Vol 213 pp: 864. e1-864.e11. Dec. 2015
[4]	Ashwal E¹, Melamed N, Hiersch L, et al. “The incidence and risk factors for retained placenta after vaginal delivery - a single center experience.’’
[5]	Endler M, Saltvedt S, Cnattingius S, et al. “Retained placenta is associated with pre-eclampsia, stillbirth, giving birth to a small-for-gestational-age infant, and spontaneous preterm birth: a national register-based study.’’ BJOG. vol 121 pp1462-1470, Nov, 2014
[6]	Panpaprai P, Boriboonhirunsarn D, et al. “Risk factors of retained placenta in Siriraj Hospital,’’ J Med Assoc Thai. Vol90, pp. 1293-1297, July 2007
[7]	Endler M, Grünewald C, Saltvedt S. “Epidemiology of retained placenta: oxytocin as an independent risk factor,’’ Obstet Gynecol, Vol 119, pp.801-809, April 2012
[8]	Green LK, Harris RE. “Uterine anomalies. Frequency of diagnosis and associated obstetric complications,’’ Obstet Gynecol, Vol 47, pp. 427-429, April 1976
[9]	C. M. Choy, W. C. Lau, W. H. Tam, P. M. Yuen. “A randomized controlled trial of intramuscular syntometrine and intravenous oxytocin in the management of the third stage of labour’’ BJOG, Vol 109, pp. 173–177, 2002
[10]	Orji E, Agwu F, Loto O, Olaleye O. “A randomized comparative study of prophylactic oxytocin versus ergometrine in the third stage of labor.’’Int J Gynaecol Obstet, Vol 101, pp 129-132, May 2008

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APA Style

Hirokazu Naoi, Keiichi Kumasawa, Hitomi Nakamura, Aiko Nishikawa, Tadashi Kimura, et al. (2016). Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery. Journal of Gynecology and Obstetrics, 4(2), 7-11. https://doi.org/10.11648/j.jgo.20160402.11

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ACS Style

Hirokazu Naoi; Keiichi Kumasawa; Hitomi Nakamura; Aiko Nishikawa; Tadashi Kimura, et al. Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery. J. Gynecol. Obstet. 2016, 4(2), 7-11. doi: 10.11648/j.jgo.20160402.11

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AMA Style

Hirokazu Naoi, Keiichi Kumasawa, Hitomi Nakamura, Aiko Nishikawa, Tadashi Kimura, et al. Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery. J Gynecol Obstet. 2016;4(2):7-11. doi: 10.11648/j.jgo.20160402.11

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@article{10.11648/j.jgo.20160402.11,
  author = {Hirokazu Naoi and Keiichi Kumasawa and Hitomi Nakamura and Aiko Nishikawa and Tadashi Kimura and Kazuhide Ogita},
  title = {Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {4},
  number = {2},
  pages = {7-11},
  doi = {10.11648/j.jgo.20160402.11},
  url = {https://doi.org/10.11648/j.jgo.20160402.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20160402.11},
  abstract = {A retained placenta after delivery can lead to bleeding and infection or other serious complications. There are 2 approaches for managing this condition: one is observation until spontaneous expulsion or resorption of the placenta, the other is active intervention such as manual removal, dilation and evacuation, uterine artery embolization, and hysterectomy. In this study, we investigated cases of retained placenta in our institution. We reviewed cases of retained placenta treated in our institution to investigate the associated risk factors and provide indications for its clinical management. 28 patients with retained placenta were treated in our institution from April 1, 2008 to March 31, 2012. Clinical background, management, and prognosis were retrospectively reviewed. Induced or augmented labor, primipara, pregnancy after reproductive technology and post-term delivery after 41 weeks were found to be risk factors for retained placenta in this study. Patients with severe complications showed a significantly larger maximum diameter of the retained placenta than those without serious complications. Patients showing partial retention of the placenta with a maximum diameter < 3 cm are at a reduced risk of serious complications and should be managed by observation.},
 year = {2016}
}

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TY  - JOUR
T1  - Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery
AU  - Hirokazu Naoi
AU  - Keiichi Kumasawa
AU  - Hitomi Nakamura
AU  - Aiko Nishikawa
AU  - Tadashi Kimura
AU  - Kazuhide Ogita
Y1  - 2016/04/13
PY  - 2016
N1  - https://doi.org/10.11648/j.jgo.20160402.11
DO  - 10.11648/j.jgo.20160402.11
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 7
EP  - 11
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20160402.11
AB  - A retained placenta after delivery can lead to bleeding and infection or other serious complications. There are 2 approaches for managing this condition: one is observation until spontaneous expulsion or resorption of the placenta, the other is active intervention such as manual removal, dilation and evacuation, uterine artery embolization, and hysterectomy. In this study, we investigated cases of retained placenta in our institution. We reviewed cases of retained placenta treated in our institution to investigate the associated risk factors and provide indications for its clinical management. 28 patients with retained placenta were treated in our institution from April 1, 2008 to March 31, 2012. Clinical background, management, and prognosis were retrospectively reviewed. Induced or augmented labor, primipara, pregnancy after reproductive technology and post-term delivery after 41 weeks were found to be risk factors for retained placenta in this study. Patients with severe complications showed a significantly larger maximum diameter of the retained placenta than those without serious complications. Patients showing partial retention of the placenta with a maximum diameter < 3 cm are at a reduced risk of serious complications and should be managed by observation.
VL  - 4
IS  - 2
ER  -

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Author Information

Hirokazu Naoi

Department of Obstetrics and Gynecology, Osaka University, Suita City, Japan
Keiichi Kumasawa

Department of Obstetrics and Gynecology, Osaka University, Suita City, Japan
Hitomi Nakamura

Department of Obstetrics and Gynecology, Osaka University, Suita City, Japan
Aiko Nishikawa

Department of Obstetrics and Gynecology, Osaka University, Suita City, Japan
Tadashi Kimura

Department of Obstetrics and Gynecology, Osaka University, Suita City, Japan
Kazuhide Ogita

Department of Obstetrics and Gynecology, Rinku General Medical Center, Izumisano City, Japan

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Plain Text BibTeX RIS

APA Style

Hirokazu Naoi, Keiichi Kumasawa, Hitomi Nakamura, Aiko Nishikawa, Tadashi Kimura, et al. (2016). Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery. Journal of Gynecology and Obstetrics, 4(2), 7-11. https://doi.org/10.11648/j.jgo.20160402.11

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ACS Style

Hirokazu Naoi; Keiichi Kumasawa; Hitomi Nakamura; Aiko Nishikawa; Tadashi Kimura, et al. Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery. J. Gynecol. Obstet. 2016, 4(2), 7-11. doi: 10.11648/j.jgo.20160402.11

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AMA Style

Hirokazu Naoi, Keiichi Kumasawa, Hitomi Nakamura, Aiko Nishikawa, Tadashi Kimura, et al. Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery. J Gynecol Obstet. 2016;4(2):7-11. doi: 10.11648/j.jgo.20160402.11

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@article{10.11648/j.jgo.20160402.11,
  author = {Hirokazu Naoi and Keiichi Kumasawa and Hitomi Nakamura and Aiko Nishikawa and Tadashi Kimura and Kazuhide Ogita},
  title = {Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {4},
  number = {2},
  pages = {7-11},
  doi = {10.11648/j.jgo.20160402.11},
  url = {https://doi.org/10.11648/j.jgo.20160402.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20160402.11},
  abstract = {A retained placenta after delivery can lead to bleeding and infection or other serious complications. There are 2 approaches for managing this condition: one is observation until spontaneous expulsion or resorption of the placenta, the other is active intervention such as manual removal, dilation and evacuation, uterine artery embolization, and hysterectomy. In this study, we investigated cases of retained placenta in our institution. We reviewed cases of retained placenta treated in our institution to investigate the associated risk factors and provide indications for its clinical management. 28 patients with retained placenta were treated in our institution from April 1, 2008 to March 31, 2012. Clinical background, management, and prognosis were retrospectively reviewed. Induced or augmented labor, primipara, pregnancy after reproductive technology and post-term delivery after 41 weeks were found to be risk factors for retained placenta in this study. Patients with severe complications showed a significantly larger maximum diameter of the retained placenta than those without serious complications. Patients showing partial retention of the placenta with a maximum diameter < 3 cm are at a reduced risk of serious complications and should be managed by observation.},
 year = {2016}
}

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TY  - JOUR
T1  - Investigation of the Prognosis of 28 Patients with Retained Placenta After Delivery
AU  - Hirokazu Naoi
AU  - Keiichi Kumasawa
AU  - Hitomi Nakamura
AU  - Aiko Nishikawa
AU  - Tadashi Kimura
AU  - Kazuhide Ogita
Y1  - 2016/04/13
PY  - 2016
N1  - https://doi.org/10.11648/j.jgo.20160402.11
DO  - 10.11648/j.jgo.20160402.11
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 7
EP  - 11
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20160402.11
AB  - A retained placenta after delivery can lead to bleeding and infection or other serious complications. There are 2 approaches for managing this condition: one is observation until spontaneous expulsion or resorption of the placenta, the other is active intervention such as manual removal, dilation and evacuation, uterine artery embolization, and hysterectomy. In this study, we investigated cases of retained placenta in our institution. We reviewed cases of retained placenta treated in our institution to investigate the associated risk factors and provide indications for its clinical management. 28 patients with retained placenta were treated in our institution from April 1, 2008 to March 31, 2012. Clinical background, management, and prognosis were retrospectively reviewed. Induced or augmented labor, primipara, pregnancy after reproductive technology and post-term delivery after 41 weeks were found to be risk factors for retained placenta in this study. Patients with severe complications showed a significantly larger maximum diameter of the retained placenta than those without serious complications. Patients showing partial retention of the placenta with a maximum diameter < 3 cm are at a reduced risk of serious complications and should be managed by observation.
VL  - 4
IS  - 2
ER  -

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