Ten-year review of burden and outcomes of retained placenta following vaginal delivery at the Delta State University Teaching Hospital, Nigeria.

Abstract

Retained placenta is a significant cause of maternal and neonatal morbidity and death in developing nations, particularly among unbooked and high-risk mothers. Objective: To assess the prevalence, clinical features, treatment approaches, and complications associated with retained placenta at Delta State University Teaching Hospital (DELSUTH). Methodology: This was a retrospective descriptive study from January 2011 to December 2020. Data were extracted from patients’ clinical records using a structured pro forma. Variables included were socio-demographic characteristics, place of delivery, clinical features, treatment modalities, and outcomes. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 28. Results: The prevalence of retained placenta was 1.2%. The mean age of the study population was 29.62 ± 6.49 years, with most patients being multiparous (52.4%), unbooked (71.4%), and possessing secondary education (52.4%). More than half (52.4%) were delivered at home and at traditional birth attendants’ places. Common clinical presentations included snapped cord (47.6%) and active bleeding (38.1%). The most frequently used treatment method was manual removal of the placenta (61.9%). The common maternal complications were postpartum haemorrhage (81.0%) and postpartum anaemia affecting over half of the women (57.1%). Blood transfusion became necessary in 85.7% of cases. Among neonatal complications, NICU admissions accounted for 47.6%, while prematurity and stillbirths
occurred in 23.8% and 19.0% of cases, respectively. Conclusion: Retained placenta is associated with adverse pregnancy outcomes, and the women commonly affected are those with unsupervised pregnancy and delivery or supervision of unskilled birth attendants. Discouraging deliveries outside standard health institutions and encouraging emergency obstetric care are crucial in reducing the burden of this preventable obstetric complication.