Manual removal of placenta at Ramathibodi Hospital 1985-1988.

In obstetrics, the need to perform manual removal of placenta is not infrequent. This was a retrospective study of placental removal among all vaginal deliveries at Ramathibodi Hospital from 1985 to 1988. The incidence of manual removal of placenta was 2.1 per 100 parturients which was higher than other reports. The reason for this is still unclear. The patients' age was mostly 26-30 years with multiparity accounting for 73.1 per cent and most deliveries occurred between 38-40 weeks of gestational age. The indication for manual removal of placenta was mostly placental retention. Previous history of curettage in the last gravida accounted for 34.7 per cent of cases. In two cases (0.5%), the procedure failed due to placenta accreta and hysterectomy was required.