Acta obstetricia et gynecologica Scandinavica · 1999
Manual removal of the placenta. Incidence and clinical significance.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tandberg A, Albrechtsen S, Iversen O E
Аннотация
OBJECTIVE: To determine the incidence and complications related to manual removal of the placenta.
METHODS: Review of hospital medical records from 1990 throughout 1994. One thousand five hundred and two vaginal deliveries from 1984 1992 were used for comparisons.
RESULTS: A total of 24,750 deliveries were registered during the five year study period. Placenta was removed manually in 165 women (0.6%). The use of general anesthesia for manual removal of placenta decreased from 74% in 1990 to 19% in 1994. Spinal analgesia was applied from 1993, and it was used in 42% of the women in 1994. Of 74 parous women, 12 (16%) had experienced retained placenta before. The average difference in the hemoglobin concentration between the prenatal and the postoperative values was 3.4 g/dl among the patients, and 10% required blood transfusion (1-4 units). Among the controls, there was no decrease in the average hemoglobin concentration, and only 0.5 needed blood transfusion. Endometritis following manual removal was detected in 1.8% of the patients and 1.5% among the controls. Despite manual removal, five women (3%) were considered to have retained placental fragments two days or later after delivery, which required curettage.
CONCLUSIONS: Placenta needed to be removed manually in 0.60% of all deliveries in our department. It was associated with increased incidence of hemorrhage and consequently low hemoglobin values. Women with a history of retained placenta have an increased risk of recurrence of retained placenta in subsequent deliveries.
METHODS: Review of hospital medical records from 1990 throughout 1994. One thousand five hundred and two vaginal deliveries from 1984 1992 were used for comparisons.
RESULTS: A total of 24,750 deliveries were registered during the five year study period. Placenta was removed manually in 165 women (0.6%). The use of general anesthesia for manual removal of placenta decreased from 74% in 1990 to 19% in 1994. Spinal analgesia was applied from 1993, and it was used in 42% of the women in 1994. Of 74 parous women, 12 (16%) had experienced retained placenta before. The average difference in the hemoglobin concentration between the prenatal and the postoperative values was 3.4 g/dl among the patients, and 10% required blood transfusion (1-4 units). Among the controls, there was no decrease in the average hemoglobin concentration, and only 0.5 needed blood transfusion. Endometritis following manual removal was detected in 1.8% of the patients and 1.5% among the controls. Despite manual removal, five women (3%) were considered to have retained placental fragments two days or later after delivery, which required curettage.
CONCLUSIONS: Placenta needed to be removed manually in 0.60% of all deliveries in our department. It was associated with increased incidence of hemorrhage and consequently low hemoglobin values. Women with a history of retained placenta have an increased risk of recurrence of retained placenta in subsequent deliveries.