Abstract
Objective: Retained placenta is a serious complication of
vaginal birth. The ability to predict retained placenta may have
positive effect on timely management. We aimed to evaluate the maternal
and obstetric risk factors associated with retained placenta after
singleton live vaginal birth Methods: A retrospective cohort of
women who had retained placenta after singleton live vaginal birth ≥ 24
weeks, compared in 1:2 ratio with women who had normal vaginal delivery
without complications. Study and control group were matched for maternal
age, gestational age and parity. Multivariate regression analysis was
performed to evaluate the potential risk factors for retained placenta
including maternal and obstetrical characteristics Results:
Fifteen thousand two hundred sixty women underwent vaginal delivery at
our medical center between 2015-2022. One hundred seventy women (1.1%)
were diagnosed with retained placenta. Ninety-nine women (0.65%) who
met the inclusion criteria, were matched with 198 women (1.3%) as
controls. Multivariate logistic regression revealed various potential
risk factors not previously described as associated with retained
placenta including: IVF pregnancy (OR 3.8, 95% CI [1.3- 11.7], P
0.018), preeclampsia (OR 4.5, 95% CI[1.1- 17.5 ],P 0.0315), women
with large for gestational age fetus (OR 28.2, 95% CI [5.4- 148.5],
P 0.0298),labor Induction (OR 21.8, 95%CI [5.5- 86.8],P
<0.001), vacuum assisted vaginal delivery (OR 2.3 .95% CI
[1.2- 4.5], P 0.011), and Duration of second stage > 3
hours (OR 3.9,95%CI [1- 15.1], P <0.001)
Conclusion: Our study highlights unreported risk factors
associated with retained placenta such as macrosomia , in vitro
fertilization and endometriosis. This emphasis on early risk
identification and the exploration of possible preventive measures holds
promise for enhancing antenatal care practices, ultimately improving
outcomes for both mothers and infants .