بررسي شيوع خروج دستي جفت ، عوامل همراه و عوارض آن در زايمان هاي واژينال

Prevalence of manual removal of placenta and its complications in vaginal delivery

Background.ʹ Manual removal of placenta is a major concern during delivery. Its prevalence and complications vary in our region, thus, the present study was conducted to determine the prevalence of manual removal of placenta and its complications in vaginal delivery in Shabih Khani hospital in Kashan in 2002 and 2003. Materials and methods. This cross sectional study was performed on all parturients referring during the study period. Prevalence of manual removal of placenta, demographic and midwifery factors as well as complications were all recorded. Results: Of 3633 vaginal deliveries with gestational age of greater than 20 weeks, 136 cases (3.7%) referred for evacuating corpus luteum. Manual removal of the placenta was performed due to incomplete placenta or decidua formation in 111 cases (81.6%) and massive bleeding in 6 cases (4.4%). Most of the studied subjects (64.7%) were 20-29 years old, and 8.8% had gestational age of less than 37 weeks. 62 were primigravida and gravidity of _>3 was reported in 3 cases (9.5%). Previous history of evacuating corpus luteum was found in 12.5%, uterine scar in 0.7% and manual removal of placenta in 5.4%. Postpartum bleeding was the most common complication (12.5%). Endometriosis was found in 4.4% and uterine rupture and hysterectomy in 0.07%ʹof the cases. Conclusion: High prevalence of evacuating corpus luteum and its complications are matter of concerns. Therapeutic and preventive interventions are highly recommended.