Patterns, Predictors and Delays in Diagnosing Retained Placenta: Insights from a Tertiary Health Facility in Southern Nigeria

Abstract

etained placenta is a cause of maternal morbidity and mortality in sub-Saharan Africa, and its subtypes, predictors and diagnostic delays are not adequately documented. We sought to determine the clinical subtypes, predisposing factors, and delays in diagnosing retained placenta in women treated at Delta State University Teaching Hospital (DELSUTH), Oghara. This study reviewed the cases of 21 women with retained placenta treated at the Obstetrics and Gynaecology department of DELSUTH from January 1st, 2011 to December 31st, 2020. Socio-demographic features, risk factors, types of retained placenta, and time to diagnosis were extracted from the patients' case files. Statistical analysis was done using Chi-square and logistic regression, with a significance level set at p<0.05. The mean age was 29.8 ± 5.4 years. Most patients were unbooked 15 (71.4%) and multiparous 11 (52.4%). Unbooked pregnancy 15 (71.4%), preterm delivery 10 (47.6%), and previous D&C 8 (38.1%) were common risk factors. The commonest subtype was trapped placenta 11 (52.4%) and the average diagnostic duration of retained placenta was 82.0 ± 36.9 minutes. High parity (AOR: 26.28, p=0.032) and previous D&C (AOR: 17.14, p=0.034) emerged as independent predictors. Retained placenta is more prevalent among unbooked patients and diagnostic delays for retained placenta are common. High parity and previous uterine procedures such as dilatation and curettage are important predictors of adherent placenta. To reduce associated complications, it is crucial to provide supervised antenatal care, identify risks, and enhance monitoring of labour.