Treatment Outcome of Retained Placenta at The University of Port Harcourt Teaching Hospital: A Five-Year Review

Abstract

Background: Retained placenta is one of the major causes of primary and secondary post-partum haemorrhage and is associated with increased risk of maternal morbidity and mortality.
Objective: To determine the prevalence, evaluate the risk factor, clinical presentation and treatment outcome of retained placenta in the University of Port Harcourt Teaching Hospital (UPTH).
Methodology: This was a retrospective study from January 1st, 2014 to December 31st, 2018. Relevant information were retrieved from patients’ clinical records and analysed using statistical package for social science (SPSS) version 25.
Result: The prevalence of retained placenta was 0.98%. forty-six out of 50 patients (92.0%) with retained placenta had unsupervised home deliveries which accounted for majority of the risk factors. Thirty-nine (78.0%) patients presented with snapped umbilical cord, 24 (48.0%) patients with active vaginal bleeding and seven (14.0%) patients were in circulatory shock at presentation. Manual removal of placenta was carried out for all patients as the major mode of management while 21 (42.0%) patients had concomitant oxytocin administration. Thirty (60%) patients had primary postpartum haemorrhage. Twenty-six (52%) patients had anaemia at presentation while 6 (12%) and 2 (4%) patients had puerperal sepsis and genital tract lacerations, respectively. No maternal mortality from retained placenta was recorded within the study period.
Conclusion: Retained placenta is essentially a disease of the unbooked patient and can lead to dire consequences. The utilization of antenatal care, skilled birth attendance and the provision of emergency obstetric care services can reduce the adverse effects of retained placenta.