Abstract
Aim:Toassesswhichmethodofplacentaremovalhasmorebeneficialeffects,spontaneousremovalormanualremovalandadheretopracticesthatbenefitthepatient. Design:RETROSPECTIVECOHORTSTUDY Methodology: SampleSize:100 Inclusioncriteria: PostnatalpatientsProcedure:Thisstudyisaretrospectivecohortstudy.ThestudypopulationwillbepostnatalpatientswhodeliveredinChettinadHospital. After getting informed consent, the procedure will be explained thoroughly to the participantsand only the participants who are willing to take part in the study will be selected. Theparticipantswereobservedonanoutpatientbasisandthosewhowereadmittedinthepostnatalward. Parturients undergoing cesarean delivery were prospectively randomized to have theplacenta removed manually or spontaneously. Patients were excluded from participation if theyhad received intrapartum prophylactic antibiotics or had been determined to havechorioamnionitis. After delivery of the infant, women in the manual group had the placentaextracted by the primary surgeon, whereas women in the spontaneous group had the placentadelivered by gentle traction on the umbilical cord. All study subjects received perioperativeprophylactic antibiotics. Their pre operative and post operative reports were analyzed forHaemoglobin counts, their course of antibiotics and days of antibiotics taken post operativelywastakenintoconsideration,symptomssuchasDizziness,palpitations,headacheTirednessorweakness were asked to the patients and their complete blood counts report, urine routinereportswerecollectedtobecomparedpreandpostoperatively. Thisstudyisainvasivestudy. StudyDuration:2months(4/10/2023-04/12/2023)Results: A total of 100 women were enrolled in the investigation, with 48 assigned to the manual removalgroup and 52 allocated to have spontaneous removal. There were no statistically significantdifferencesinmeangestationalage,frequencyordurationofrupturedmembranes,frequencyordurationoflabor,ormeannumberofvaginalexaminationsbetweenthetwostudygroups. Postoperative infections occurred in 5 of 52 women in the spontaneous delivery groupcomparedwith12of48womeninwhichtheplacentawasmanuallyextracted.Subsetanalysisof patients delivered with ruptured membranes similarly demonstrated a statistically significantreduction in the incidence of postoperative infections with spontaneous placental removalcompared with manual extraction There was a similar trend toward a reduction in post deliveryinfectionsassociatedwithspontaneousplacentalremovalinwomenwithintactmembranes. Conclusion:Spontaneous delivery of the placenta after cesarean delivery is associated with a decrease intheincidenceofpostcesareaninfectionsandanemicsymptomscomparedtomanualremovaloftheplacenta.
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