STUDY OF EFFECTS OF SPONTANEOUS DELIVERY OF PLACENTA VERSUS MANUAL REMOVAL OF PLACENTA DURING CESAREAN SECTION AT TERTIARY CARE CENTRE
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i4.44654Keywords:
Manual removal placenta,, Caesarean Section, Tertiary centerAbstract
Objectives: The aim of the study was to compare the effects of manual removal of placenta and spontaneous delivery of placenta during cesarean section.
Methods: This was a hospital-based prospective comparative study conducted in the Department of Obstetrics and Gynecology, Jhalawar Medical College, Jhalawar. 400 antenatal women at term and singleton pregnancy posted for cesarean section from October 2018 to September 2019 for 1 year duration. The study populations were divided into two groups (200 each). Group A in whom placenta deliver spontaneously and Group B in whom placenta was removed manually. Comparison was done in term of blood loss, fever, endometritis, and delayed complications.
Results: The manual removal of placenta associated with greater blood loss (p<0.0001, statistically significant), the greater fall in hemoglobin (p<0.0001, statistically significant). Manual removal of placenta was associated with leukocytosis (p=0.0009), higher incidence of fever, post-operative uterine tenderness, and sub involution of uterus (p<0.05 statistically significant). This is reflected by increased incidence of endometritis with manual removal (p=0.001, Significant). The overall time taken between delivery of baby to delivery of placenta was significantly lesser in manual removal method (p<0.0001).
Conclusion: Manual method seems to decrease the time interval between delivery of baby and that of placenta. Manual removal of placenta does more harm than benefit by increasing the incidence of fall in hemoglobin and delayed complication.
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