Suma Varsha, Vanaja Kandluri, Usha Brindhini, Jahnavi Esanakula
BACKGROUND The objectives of this study were to assess intra operative advantages and disadvantages, surgical benefits and problems, and postoperative febrile morbidity following spontaneous delivery of placenta, as compared to manual removal of placenta during caesarean section. MATERIALS AND METHODS Pregnant women with term gestation admitted as in-patients in SVIMS, Sri Padmavathi Medical College, Tirupathi over a period of 2 years from June 2015 to May 2017. 200 women scheduled for lower segment caesarean section through Pfannenstiel incision were randomized into spontaneous expulsion or manual removal of placenta group and their intraoperative and postoperative outcomes were studied which were statistically compared. RESULTS There was significant reduction in perioperative haemoglobin and PCV decrease (P<0.05) and duration of hospital stay (P<0.05) in the group where placenta was expelled spontaneously as compared to those in manual removal group. The shorter duration of hospital stay was due to decreased febrile morbidity and lesser postoperative blood transfusions. There was also a significant number with endometritis in MROP group. There was no significant difference in the operating time between both the groups. CONCLUSION Spontaneous delivery of placenta is associated with lesser perioperative Hb and PCV fall and reduced febrile morbidity, leading to shorter hospital stay as compared to manual removal of placenta during caesarean section.
