A Study on Clinical Presentation, Predisposing Factors and Outcome of Retained Placenta

Open Access

Abstract

Background: Retained placenta is a significant obstetric complication associated with increased maternal morbidity and mortality. Objective: This study aimed to assess the clinical presentation, predisposing factors, and outcomes of retained placenta among women delivering in a tertiary care setting. Methods & Materials: This case control study was conducted in the Department of Obstetrics & Gynaecology, Dhaka Medical College and Hospital, Dhaka, Bangladesh, from January 2012 to June 2012. A total of 100 patients were enrolled, comprising 50 patients with retained placenta were taken as cases and 50 patients without retained placenta were taken as controls. Results: This study shows that age and parity differed significantly between groups, with higher parity more common among cases. Retained placenta was strongly associated with mismanagement of the third stage of labor (30% vs. 4%), previous uterine surgery (20% vs. 4%), preterm labor (22% vs. 8%), and grand multiparity (16% vs. 2%). Clinically, cases had higher rates of primary postpartum hemorrhage (50%), anemia (80%), and shock (30%). Although adverse maternal outcomes were more frequent among cases, differences were not statistically significant. Multivariate analysis identified mismanagement of the third stage of labor (AOR 2.80), previous uterine surgery (AOR 9.20), preterm labor (AOR 3.79), and grand multiparity (AOR 4.67) as independent predictors. Conclusion: Retained placenta is strongly associated with preventable obstetric factors and presents with significant clinical complications. Early identification of high-risk women and improved management of the third stage of labor are essential for reducing adverse outcomes.