Frequency of Retained Placenta and Common Factors Leading to it Among Patients Presenting with Post-Partum Hemorrhage

Authors

  • Sumaira Naseem Obstetrics and Gynecology Department, Khyber Teaching Hospital, Peshawar, KP, Pakistan.
  • Tayaba Mazhar Obstetrics and Gynecology Department, Khyber Teaching Hospital, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i4.2666

Keywords:

Antenatal Care, Cesarean Section, Grand Multiparity, Postpartum Hemorrhage, Preterm Delivery, Retained Placenta.

Abstract

Background: Retained placenta refers to a situation where placenta takes longer than normal to be delivered from the uterus, thereby posing risks of complications like bleeding. This condition has been considered a major cause of severe bleeding in mothers. There are various factors that contribute to this condition, including being a preterm delivery, unbooked, and a grand multipara. Objective: To determine the frequency of retained placenta and identify common factors leading to its occurrence among patients presenting with postpartum hemorrhage. Study Design: Cross-sectional study. Duration and Place of Study: This study was conducted from January 1, 2023, to July 1, 2023 at the Obstetrics and Gynecology Department of Khyber Teaching Hospital, Peshawar. Methodology: A total of 246 female patients, aged 25-50 years, presenting with postpartum hemorrhage were included in the study. Data on demographic details, antenatal care, prior pregnancies, mode of delivery, and potential risk factors for retained placenta were collected. The frequency of retained placenta and factors such as preterm delivery, unbooked status, grand multiparity, previous dilation and curettage, and previous cesarean section were assessed. Statistical analysis was performed using SPSS version 25, and chi-square tests were applied for association analysis (p ≤ 0.05). Results: Out of 246 patients, 37 (15.00%) had retained placenta. The most common risk factors were preterm delivery (78.40%), unbooked status (62.20%), and grand multiparity (56.80%). Statistically significant associations were observed between retained placenta and maternal age ≤30 years (p = 0.005) and parity >2 (p = 0.006). Conclusion: Retained placenta is a significant contributor to postpartum hemorrhage in the studied population. Preterm delivery, unbooked status, and grand multiparity were identified as the most common factors leading to retained placenta.

Downloads

Download data is not yet available.

References

1. Perlman, N. C., & Carusi, D. A. (2019). Retained placenta after vaginal delivery: risk factors and management. International Journal of Women's Health, 11, 527-534.

https://doi.org/10.2147/ijwh.s218933

2. Tchuinte Lekuikeu, L. S., & Moreland, C. (2022). Retained placenta and postpartum hemorrhage: A case report and review of literature. Cureus.

https://doi.org/10.7759/cureus.24389

3. Pan, S., Liu, J., Han, M., Han, Y., Lu, Y., Zuo, Q., Huang, S., & Ge, Z. (2025). The experience of manual removal of placenta in women with retained placenta: A qualitative study. BMC Pregnancy and Childbirth, 25(1).

https://doi.org/10.1186/s12884-025-08375-5

4. Tchuinte Lekuikeu, L. S., & Moreland, C. (2022). Retained placenta and postpartum hemorrhage: A case report and review of literature. Cureus.

https://doi.org/10.7759/cureus.24389

5. Sothornwit, J., Ngamjarus, C., Pattanittum, P., Waidee, T., Jampathong, N., Jongjakapun, A., Kongwattanakul, K., & Lumbiganon, P. (2024). Uterotonics for management of retained placenta. Cochrane Database of Systematic Reviews, 2024(10).

https://doi.org/10.1002/14651858.cd016147

6. Hoque, A. M., Buckus, S., & Hoque, M. (2024). Incidence of post-partum complications and referrals of mothers and neonates to hospitals from a midwife obstetric unit. African Health Sciences, 24(2), 243-254.

https://doi.org/10.4314/ahs.v24i2.27

7. Ansari, N., Maruf, F., Manalai, P., Currie, S., Soroush, M. S., Amin, S. S., Higgins-Steele, A., Kim, Y. M., Stekelenburg, J., Van Roosmalen, J., & Tappis, H. (2020). Quality of care in prevention, detection and management of postpartum hemorrhage in hospitals in Afghanistan: An observational assessment. BMC Health Services Research, 20(1).

https://doi.org/10.1186/s12913-020-05342-y

8. Vornic, I., Buciu, V., Furau, C. G., Zara, F., Novacescu, D., Barb, A. C., Cumpanas, A. A., Latcu, S. C., Sas, I., Serban, D., Cut, T. G., & Dumitru, C. S. (2024). The interplay of molecular factors and morphology in human placental development and implantation. Biomedicines, 12(12), 2908.

https://doi.org/10.3390/biomedicines12122908

9. Favilli, A., Tosto, V., Ceccobelli, M., Parazzini, F., Franchi, M., Bini, V., & Gerli, S. (2021). Risk factors for non-adherent retained placenta after vaginal delivery: A systematic review. BMC Pregnancy and Childbirth, 21(1).

https://doi.org/10.1186/s12884-021-03721-9

10. Perlman, N. C., & Carusi, D. A. (2019). Retained placenta after vaginal delivery: risk factors and management. International Journal of Women's Health, 11, 527-534.

https://doi.org/10.2147/ijwh.s218933

11. Nasser, B., Jadaon, J., Awad-Khamaisy, N., Lfoul, L. A., & Hendler, I. (2024). Novel risk factors associated with retained placenta after vaginal birth.

https://doi.org/10.22541/au.171729419.91889478/v1

12. Muniro, Z., Tarimo, C. S., Mahande, M. J., Maro, E., & Mchome, B. (2019). Grand multiparity as a predictor of adverse pregnancy outcome among women who delivered at a tertiary hospital in northern Tanzania. BMC Pregnancy and Childbirth, 19(1).

https://doi.org/10.1186/s12884-019-2377-5

13. Arrowsmith, S. (2023). Multiple pregnancies, the myometrium and the role of mechanical factors in the timing of labour. Current Research in Physiology, 6, 100105.

https://doi.org/10.1016/j.crphys.2023.100105

14. Cohen, A., Gutman-Ido, E., Karavani, G., Albeck, A., Rosenbloom, J. I., Shushan, A., & Chill, H. H. (2023). The association between history of retained placenta and success rate of misoprostol treatment for early pregnancy failure. BMC Women's Health, 23(1).

https://doi.org/10.1186/s12905-023-02666-9

15. Belachew, J., Eurenius, K., Mulic-Lutvica, A., & Axelsson, O. (2017). Placental location, postpartum hemorrhage and retained placenta in women with a previous cesarean section delivery: A prospective cohort study. Upsala Journal of Medical Sciences, 122(3), 185-189.

https://doi.org/10.1080/03009734.2017.1356405

16. Abrar, S., Abrar, T., & Sayyed, E. (2016). Retained placenta and postpartum haemorrhage. Journal of Medical Sciences, 24(1), 2-4.

https://jmedsci.com/index.php/Jmedsci/article/view/172

17. Munir, S. I., Sadiq, A., & Ishtiaq, S. (2015). Frequency of causes of primary postpartum haemorrhage in a tertiary care hospital. Annals of King Edward Medical University, 21(1), 33-33.

https://annalskemu.org/journal/index.php/annals/article/view/692

18. Shams, N., Yasmin, H., Anwer, S. B., Bai, K., & Rubab, B. (2020). Frequency of retained placenta in patients presenting with postpartum haemorrhage after active management of third stage of labour. International Journal Of Community Medicine And Public Health, 7(11), 4256.

https://doi.org/10.18203/2394-6040.ijcmph20204433

19. Obajimi, G., Roberts, A., Aimakhu, C., Bello, F., & Obajimi, O. (2011). An appraisal of retained placentae in Ibadan: A five year review. Annals of Ibadan Postgraduate Medicine, 7(1).

https://doi.org/10.4314/aipm.v7i1.64058

20. Cohen, G., Kovo, M., Biron‐Shental, T., Markovitch, O., Daykan, Y., & Schreiber, H. (2023). Risk factors for retained placenta in a first pregnancy—A clinical trial. International Journal of Gynecology & Obstetrics, 163(1), 194-201.

https://doi.org/10.1002/ijgo.14800

21. Favilli, A., Tosto, V., Ceccobelli, M., Parazzini, F., Franchi, M., Bini, V., & Gerli, S. (2021). Risk factors for non-adherent retained placenta after vaginal delivery: A systematic review. BMC Pregnancy and Childbirth, 21(1).

https://doi.org/10.1186/s12884-021-03721-9

22. Gani, G. N., & Ali, A. T. (2013). Prevalence and factors associated with maternal postpartum haemorrhage in Khyber Agency, Pakistan. Journal of Ayub Medical College Abbottabad, 25(1-2), 81-85.

https://ayubmed.edu.pk/jamc/index.php/jamc/article/view/1858

23. Habib, S., Malik, F. R., & Malik, N. N. (2018). Retained Placenta: An obstetric emergency and cause of reproductive morbidity. Rawal Medical Journal, 43(2), 276-276.

24. GUL, F., AFTAB, A., AFTAB, M., AJMAL, H., & SARWAR, S. (2024). Frequency of uterine curettage as a risk factor among patients with placenta previa presenting at tertiary care hospital. Biological and Clinical Sciences Research Journal, 2024(1), 1379.

https://doi.org/10.54112/bcsrj.v2024i1.1379

Downloads

Published

2025-04-30

How to Cite

Naseem, S., & Mazhar, T. (2025). Frequency of Retained Placenta and Common Factors Leading to it Among Patients Presenting with Post-Partum Hemorrhage. Indus Journal of Bioscience Research, 3(4), 1198-1202. https://doi.org/10.70749/ijbr.v3i4.2666