An Appraisal of Retained Placenta in Sokoto: a five-year review

Abstract

Background: Retained placenta is one of the major causes of primary and secondary postpartum haemorrhage associated with increased risk of maternal morbidity and mortality.
Objective: To determine the incidence, method of treatment and maternal outcome of patients with retained placenta.
Methodology: This is a retrospective study covering a period of 5years, January 1^st, 2007 to December 31^st, 2011, in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.
Results: During the 5-year period, there were 144 cases of retained placenta out of 8569 total deliveries, giving an incidence of 1.7%. However, only 118 patients’ case records were available for analysis. Majority of the patients 88 (74.6%) were unbooked for antenatal care in UDUTH and 104 (88.1%) patients had home delivery. The identified risk factors included previous history of retained placenta 32 (27.1%) and previous uterine surgery 13 (11.0%). Fifty per cent of the patients were in hypovolaemic shock at presentation. Manual removal of the placenta was the most common mode of treatment 91 (77.1%). There were 7 maternal deaths giving a case fatality rate of 5.9%.
Conclusion: Retained placenta is a significant cause of maternal mortality and morbidity due to the associated haemorrhage and other complications related to its removal. Antenatal care, skilled birth attendant at delivery and provision of emergency obstetrics care services will help to reduce the incidence and severity.

Keywords: Morbidity, mortality, post-partum haemorrhage, Sokoto