Socio-Demogrphic Profile and Complications of Patients with Retained Placenta in a Tertiary Centre, South-South Nigeria

Abstract

Retained placenta is a life threatening emergency and a major cause of primary postpartum haemorrhage and maternal morbidity in the developing world. Objectives: To determine the socio-demographic characteristics and complications in patients presenting with retained placenta in this centre. Materials and Method: This was a retrospective study of all cases of retained placenta managed at the UCTH from January 1st 2008 to December 31st 2012. The case records of these patients were retrieved and analysed using Epi info 3.3.2. Results: There were 138 patients with retained placenta during the period, giving an incidence of 1.02%. The mean age was 27.7 ± 4.6 years with a range of 17 - 41 years. Majority of the cases of retained placenta occurred in the age group of 26 - 30 years (37%); para 4 (36.1%); traders (48.7%) and unbooked (68.1%). Most patients delivered outside the hospital by unskilled birth attendants at churches, traditional birth attendants and patient’s home (69.0%). Eleven (9.2%) patients had previous caesarean sections while 7 (5.9%) had placenta retention in the past. The complications observed were mostly primary postpartum haemorrhage 67 (56.3%) and anaemia 79 (66.4). Unbooked patients significantly had more primary postpartum haemorrhage (P-value = 0.0325) and anaemia (P-value = 0.0000) than the booked patients. Nineteen (16.0%) patients presented in shock out of which 1 died due to severe haemorrhagic shock, giving a case fatality rate of 0.8%. Conclusion: Poorly managed labour and delivery is the major cause of retained placenta. Therefore, supervised hospital delivery is paramount to reduce the observed complications.