Frequency of retained placenta in patients presenting with postpartum haemorrhage after active management of third stage of labour

Nabila Shams, Haleema Yasmin, Shaista Bashir Anwer, Kalavanti Bai, Bushra Rubab


Background: Postpartum haemorrhage (PPH) is a potentially life-threatening complication. PPH is defined as blood loss of more than 500 ml in vaginal delivery or 1000 ml in caesarean delivery. The most frequent causes are uterine atony, genital tract trauma followed by retained placenta. Active management of third stage of labour reduces the risk of postpartum haemorrhage and should be offered and recommended to all women.

Methods: It was a descriptive (cross sectional study) conducted to determine the frequency of retained placenta in patients presenting with postpartum haemorrhage after active management of third stage of labour, conducted in ward 8, Jinnah Post Graduate Medical Centre, Karachi from October, 2013 to April, 2014. A total of 189 patients with postpartum haemorrhage after receiving active management of third stage labour were included in this study. All patients were subjected to detailed history and vaginal examination to confirm retained placenta. Data was recorded in a pre-designed proforma.

Results: Frequency of retained placenta presenting with postpartum haemorrhage after active management of third stage of labour was observed in 20.11%.

Conclusion: It is concluded that active management of the third stage of labour has proved beneficial compared with expectant management based on the decrease in the PPH rate, use of additional uterotonic medication and cost of the care.



Postpartum haemorrhage, Retained placenta, Active management of third stage of labour

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