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Published in: Archives of Gynecology and Obstetrics 3/2019

01-03-2019 | Maternal-Fetal Medicine

The increasing role of a retained placenta in postpartum blood loss: a cohort study

Authors: Hellen McKinnon Edwards, Jens Anton Svare, Anne Juul Wikkelsø, Jeannet Lauenborg, Jens Langhoff-Roos

Published in: Archives of Gynecology and Obstetrics | Issue 3/2019

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Abstract

Purpose

To describe the association between quantity of blood loss, duration of the third stage of labour, retained placenta and other risk factors, and to describe the role of a retained placenta depending on the cutoff used to define postpartum haemorrhage.

Methods

Cohort study of all vaginal deliveries at two Danish maternity units between 1 January 2009 and 31 December 2013 (n = 43,357), univariate and multivariate linear regression statistical analyses.

Results

A retained placenta was shown to be a strong predictor of quantity of blood loss and duration of the third stage of labour a weak predictor of quantity of blood loss. The predictive power of the third stage of labour was further reduced in the multivariate analysis when including retained placenta in the model. There was an increase in the role of a retained placenta depending on the cutoff used to define postpartum haemorrhage, increasing from 12% in cases of blood loss ≥ 500 ml to 53% in cases of blood loss ≥ 2000 ml

Conclusion

The predictive power of duration of the third stage of labour in regard to postpartum blood loss was diminished by the influence of a retained placenta. A retained placenta was, furthermore, present in the majority of most severe cases.
Appendix
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Literature
7.
go back to reference Anderson JM, Etches D (2007) Prevention and management of postpartum hemorrhage. Am Fam Physician 75:875–882PubMed Anderson JM, Etches D (2007) Prevention and management of postpartum hemorrhage. Am Fam Physician 75:875–882PubMed
Metadata
Title
The increasing role of a retained placenta in postpartum blood loss: a cohort study
Authors
Hellen McKinnon Edwards
Jens Anton Svare
Anne Juul Wikkelsø
Jeannet Lauenborg
Jens Langhoff-Roos
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 3/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-019-05066-3

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