2024-03-28T14:05:25Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:02002064
2023-01-16T05:17:28Z
499:500:501
Manual removal of the placenta and postpartum hemorrhage: A multicenter retrospective study
Fujita, Kei
Ushida, Takafumi
Imai, Kenji
Nakano‐Kobayashi, Tomoko
Iitani, Yukako
Matsuo, Seiko
Yoshida, Shigeru
Yamashita, Mamoru
Kajiyama, Hiroaki
Kotani, Tomomi
open access
"This is the peer reviewed version of the following article: [Fujita, K., Ushida, T., Imai, K., Nakano-Kobayashi, T., Iitani, Y., Matsuo, S., Yoshida, S., Yamashita, M., Kajiyama, H. and Kotani, T. (2021), Manual removal of the placenta and postpartum hemorrhage: A multicenter retrospective study. J. Obstet. Gynaecol. Res., 47: 3867-3874. https://doi.org/10.1111/jog.15004], which has been published in final form at [https://doi.org/10.1111/jog.15004]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited."
Aim: In postpartum women, retained placenta is diagnosed in the absence of signs of placental separation and expulsion, and requires manual removal of the placenta (MROP). MROP may lead to massive hemorrhage, hemodynamic instability, and the need for emergency interventions including blood transfusion, interventional radiology, and hysterectomy. In this study, we aimed to identify the risk factors for retained placenta requiring MROP after vaginal delivery and postpartum hemorrhage (PPH) following MROP. Methods: A multicenter retrospective study was performed using data from women who delivered at term between 2010 and 2018 at 13 facilities in Japan. Of 36 454 eligible women, 112 women who required MROP were identified. Multivariate logistic regression analyses were conducted to evaluate the risk factors for retained placenta and PPH following MROP. Results: A history of abortion, assisted reproductive technology (ART), instrumental delivery, and delivery of small-for-gestational-age infant were independent risk factors for MROP (adjusted odds ratios [95% confidence intervals]: 1.93 [1.28–2.92], 8.41 [5.43–13.05], 1.80 [1.14–2.82], and 4.32 [1.97–9.48], respectively). ART was identified as an independent risk factor for PPH (adjusted odds ratio [95% confidence interval]: 6.67 [2.42–18.36]) in patients who underwent MROP. Conclusion: ART pregnancies significantly increased the risk of retained placenta requiring MROP and PPH. Our results suggest that clinicians need consider patient transfer to a higher-level facility and preparation of sufficient blood products before initiating MROP in cases of ART pregnancies. Our study may assist in identifying high-risk women for PPH before MROP and in guiding treatment decisions, especially in facilities without a blood bank.
Wiley
2022-11-01
2021-11
eng
journal article
AM
http://hdl.handle.net/2237/0002002064
https://nagoya.repo.nii.ac.jp/records/2002064
https://doi.org/10.1111/jog.15004
1341-8076
Journal of Obstetrics and Gynaecology Research
47
11
3867
3874
https://nagoya.repo.nii.ac.jp/record/2002064/files/Manual_removal_of_placenta.pdf
application/pdf
309 KB
2022-11-01