Manual placenta removal is a risk factor for recurrence of manual placenta removal in subsequent parturitions

Abstract

 ［Objective］This study aimed to evaluate the risk factors for manual placenta removal and their contribution to the risk of its recurrence.

 ［Methods］This retrospective cohort study included women with two consecutive singleton vaginal deliveries who had their latest delivery within a 6-year period from 2017 at our hospital. The primary outcome was the incidence of manual placental removal. Associations between the outcomes and previous manual placenta removal, maternal age, assisted reproductive technology（ART）pregnancy, and past artificial abortion were evaluated.

 ［Results］Based on the inclusion and exclusion criteria, 2, 488 women were analyzed, of which 30 required manual placenta removal（1.21%）. The univariate analysis revealed significant differences in the following risk factors for manual placenta removal: 1）previous manual placenta removal, 2）ART pregnancy, and 3）age at delivery ≥ 35 years. In the multivariate analysis, previous manual placenta removal（adjusted odds ratio［aOR］, 14.71; 95% confidence interval［95%CI］, 2.69‒61.57）and ART pregnancy（aOR 8.19, 95%CI 3.20‒19.49）were identified as independent risk factors associated with the risk of manual placenta removal.

 ［Conclusions］In cases of past manual placental removal or ART pregnancy, careful management is recommended due to the higher risk of manual placenta removal”.