[Influence of placental removal method on the incidence of post-cesarean infections and operation duration]

ABSTRACT

Postpartum endometritis is 1-8% and cesarean section is one of its risk factor. The present study was performed to compare the effect of manual removal and spontaneous delivery of placenta on post-cesarean endometritis and duration of cesarean operation. In this prospective [control-case] study, 280 pregnant women undergoing elective cesarean delivery in Shahid Sadoughi [Yezed, Iran] teaching hospital were randomly assigned to two groups manual placental delivery [140 women] and spontaneous placental delivery [140 women]. Antibiotic prophylaxis was administered in both groups. The operation time concluded from skin incision to skin repair. Endometritis was diagnosed in patients who developed clinical signs of fever [>38°C] 24 h after delivery, supra-pubic tenderness and vaginal discharge. Data analysis was carried out using t-test and chi square test by SPSS15.0. The total rate of endometritis was 12.1% [34 women]; 12 women in the spontaneous placental delivery group [8.6%] and 22 women in the manual placental removal group [16%]. This difference was statistically significant between two groups [P=0.006]. There was no statistically significant difference in duration of operation between two groups [P=0.1]. Our finding indicate that manual removal of the placenta increased postpartum endometritis in compared with the spontaneous method of placental removal, but had no influence on the duration of cesarean