Management of women with retained placenta and the risk of postpartum haemorrhage: A retrospective cohort study from a Swedish single centre.

OBJECTIVE

The objective of this study was to examine women with retained placenta (RP) and the risk of postpartum haemorrhage (PPH) in relation to prolonged duration of third stage of labour > 30 min vs. ≤ 30 min, nighttime childbirth vs. daytime, and manual removal of placenta in regional vs. general anaesthesia. Additionally, determine if there were any differences in amount of bleeding until or after placental detachment, or number of blood transfusions.

METHODS

This was a single-centre retrospective cohort study including women with a diagnosis of RP at Sahlgrenska University Hospital, Sweden, between January 2014 and December 2020. Data were collected from the Swedish Pregnancy Register and the Hospital Discharge Register.

RESULTS

746 women were included. A total of 84 women (84/746, 11.3 %) experienced PPH. There was no significant correlation between the duration of the third stage of labour and the amount of bleeding postpartum (p-value 0.57). A prolonged third stage of labour was not associated with an increased risk of PPH (duration > 30 min vs. ≤ 30 min: aOR 1.12, 95 % CI 0.65-1.93). Giving birth during nighttime vs. daytime was not associated with an increased risk of PPH (aOR 1.27, 95 % CI 0.68-2.37). Manual removal of the RP under regional anaesthesia vs. under general anaesthesia was not associated with an increased risk of PPH (aOR 1.12, 95 % CI 0.65-1.93); however, the number of blood transfusions was significantly lower (p-value < 0.001) under regional anaesthesia.

CONCLUSION

Prolonged third stage of labour, childbirth during nighttime, and regional anaesthesia were not associated with an increased risk of PPH in women diagnosed with RP.