- Risk factors for retained placenta after vaginal delivery include higher maternal age, longer oxytocin use, postpartum hemorrhage.
Why this matters
- Retained placenta complicates 0.5%-3% of all vaginal deliveries and is associated with hemorrhage, infection, and prolonged hospitalization.
- Exact etiology is not known.
- The rate of retained placenta was 0.6%.
- Women with a higher maternal age (P=.011), labor induction with prostaglandins (P=.014), longer use of oxytocin (P=.048), instrumental delivery (P=.0001), history of uterine curettage (P=.016), and postpartum hemorrhage (P=.0001) had a higher rate of retained placenta.
- Lower birth weight (P=.01), lower 1-minute Apgar score (P=.0001), and lower placental weight (P=.0001) were associated with increased risk for retained placenta.
- There were no differences in rate of retained placenta with history of cesarean delivery or fertility treatments.
- A predictive model with a cutoff score fixed at 61.8 has a sensitivity of 76.3% and a specificity of 75.8%.
- Retrospective case-control study between 2007 and 2017 in 2 institutions.
- Women with retained placenta after vaginal delivery were identified using ICD codes (n=138).
- Risk factors for retained placenta were identified.
- A predictive model to predict retained placenta was created.
- Funding: None.
- Retrospective design.
- Predictive model needs validation.