Retained placenta is a life threatening emergency and a major cause of
primary postpartum hae- morrhage and maternal morbidity in the developing
world. Objectives: To determine the socio- demographic characteristics and
complications in patients presenting with retained placenta in this centre. Materials
and Method: This was a retrospective study of all cases of retained placenta
managed at the UCTH from January 1st 2008 to December 31st 2012. The case
records of these patients were retrieved and analysed using Epi info 3.3.2.
Results: There were 138 patients with retained placenta during the period,
giving an incidence of 1.02%. The mean age was 27.7 ± 4.6 years with a range of
17 - 41 years. Majority of the cases of retained placenta occurred in the age
group of 26 - 30 years (37%); para 4 (36.1%); traders (48.7%) and unbooked (68.1%).
Most patients delivered outside the hospital by unskilled birth attendants at
churches, traditional birth attendants and patient’s home (69.0%). Eleven (9.2%)
patients had previous caesarean sections while 7 (5.9%) had placenta retention
in the past. The complications observed were mostly primary postpartum
haemorrhage 67 (56.3%) and anaemia 79 (66.4). Unbooked patients significantly
had more primary postpartum haemorrhage (P-value = 0.0325) and anaemia (P-value
= 0.0000) than the booked patients. Nineteen (16.0%) patients presented in
shock out of which 1 died due to severe haemorrhagic shock, giving a case
fatality rate of 0.8%. Conclusion: Poorly managed labour and delivery is the
major cause of retained placenta. Therefore, supervised hospital delivery is
paramount to reduce the observed complications.
Cite this paper
Iklaki, C. U. , Emechebe, C. I. , Njoku, C. O. , Ago, B. U. and Ugwu, B. S. (2016). Socio-Demogrphic Profile and Complications of Patients with Retained Placenta in a Tertiary Centre, South-South Nigeria. Open Access Library Journal, 3, e2364. doi: http://dx.doi.org/10.4236/oalib.1102364.
Cheung, W.M., Hawkes, A., Ibish, S. and Weeks, A.D. (2011) The Retained
Placenta: Historical and Geographical Rate Variations. Journal of Obstetrics and Gynaecology, 31, 37. http://dx.doi.org/10.3109/01443615.2010.531301
Poggi, S.B.H.
(2007) Postpartum Haemorrhage and the Abnormal Puerperium. In: Decherny, A.H.,
Goodwin, T.M., Laufer, N. and Nathan, L., Eds., Current Obstetric and Gynaecologic Diagnosis
and Treatment, 10th Edition, Lange Medical Books, McGraw-Hill, California, Vol. 31, 477-497.
World Health Organisation (2005) The World Report 2005. Attending to
136 Million Births Every Year 2005. Make Every Mother and Child Count. The
World Health Organisation, Geneva, 62-63.
Rizwan, N., Abbasi, R.M. and Jatoi, N. (2009)
Retained Placenta Still a Cause of Maternal Morbidity and Mortality. Journal Pakistan Medical Association, 59.
Adelusi, B., Soltan, M.H., Chowdhury, N. and Kangave, D. (1997) Risk of Retained Placenta: Multivariate
Approach. Acta Obstetricia et
Gynecologica Scandinavica, 76, 414-418. http://dx.doi.org/10.3109/00016349709047821
Obajimi, G.O., Roberts, A.O., Aimakhu, C.O., Bello, F.A. and Olayemi, O. (2009)
An Appraisal of Retained Placenta in Ibadan: A Five-Year Review. Annals of Ibadan Postgraduate Medicine, 7.
Carroli, G. and Bergel, E. (2004) Umbilical Vein Injection for Management
of Retained Placenta. Cochrane Database of Systematic Reviews, No. 4, CD001337.
Orji, E., Agwu, F., Loto, O. and Olaleye, O.
(2008) A Randomized Comparative Study of Prophylactic Oxytocin versus Ergometrine
in the Third Stage of Labour. International
Journal of Gynecology and Obstetrics, 101, 129-132. http://dx.doi.org/10.1016/j.ijgo.2007.11.009
Weeks, A.D., Alia, G., Vernon, G.,Namayanja, A., Gosakan, R., Majeed, T., Hart, A.,
Jafri, H., Nardin, J., Carroli, G., Fairlie, F., Raashid, Y., Mirembe, F. and
Alfirevic, Z. (2010)
Umbilical Vein Oxytocin for the Treatment of Retained Placenta (Release Study):
A Double Blind Randomised Controlled Trial. Lancet,
375, 141-147. http://dx.doi.org/10.1016/S0140-6736(09)61752-9
Rogers, M.S., Yuen, P.M. and Wong, S.
(2007) Avoiding Manual Removal of Placenta: Evaluation of Intraumbilical Vein
Injection of Uterotonics Using the Pipingas Technique for Management of
Adherent Placenta. Acta Obstetricia et
Gynecologica Scandinavica, 86, 48-54. http://dx.doi.org/10.1080/00016340601088570
Eifediyi, R.A., Eigbefoh, J.O., Isabu, P.A., Omorogbe, F.I., Ukponmwan, O.G. and Momoh, M. (2011) Retained Placenta: Still a
Cause of Maternal Morbidity and Mortality in a Nigerian Semi-Urban Population. Sudan Journal of Medical Sciences, 6, 33-38.
Etuk, S.J. and Ekanem, A.D. (2001) Sociodemographic and
Reproductive Characteristics of Women Who Default from Orthodox Obstetric Care
in Calabar, Nig. International Journal of
Gynecology and Obstetrics, 73, 57-60. http://dx.doi.org/10.1016/S0020-7292(00)00386-6
Chien, P.F.W. (2007) Third Stage of Labour and Abnormalities.
In:Edmonds, K., Ed., Dewhurst’s Textbook of Obstetrics
and Gynaecology for Postgraduates, 6th Edition, 330-341.
Njoku, C.O., Emechebe, C.I., Ekabua, J.E., Agbarakwe, H. and Abeshi, S. (2014) Utilisation and Discontinuation of Contraceptive
Methods: The University of Calabar Teaching Hospital (UCTH) Experience. Global Journal of Medicine and Public Health, 3, 5.
Soltan, M.H. and Khashoggi, T.
(1997) Retained Placenta and Associated Risk Factors. Journal of Obstetrics and Gynaecology, 17, 245-247. http://dx.doi.org/10.1080/01443619750113159
Hall, M.H., Halliwell, R. and Carr, H.R. (1985) Concomitant and Repeated Happening of Complications of Third Stage of
Labour. British Journal of Obstetrics and
Gynaecology, 92, 732-738. http://dx.doi.org/10.1111/j.1471-0528.1985.tb01456.x
Tandberg, A., Albrechsten, S. and Iversen, O.E. (1999) Manual Removal of Placenta. Incidence and Clinical Significance. Acta Obstetricia et
Gynecologica Scandinavica, 78, 33-36.
Harrison, K.A. (1985) Childbearing, Health and Social
Priorities: Survey of 22,774 Consecutive Hospital Births in Zaria, Northern
Nigeria. British Journal of Obstetrics
and Gynaecology, 92, 100-115.