Spontaneous Versus Manual Removal of Placenta During Elective Cesarean Section Regarding Blood Loss

Background: Although manual removal of the placenta is commonly carried out, opinions differ about the best technique for delivery of the placenta at caesarean section. This study aimed to compare blood loss associated with spontaneous and manual removal of the placenta during cesarean section. Methods: A prospective Cohort study was conducted at Zagazig University Hospitals and Zagazig General Hospital in the period from April 2019 to October 2019. included 48 patients were divided into two groups regarding methods of placental delivery. Group (1) placenta was allowed to be separated spontaneously and removed by gentle cord traction. Group (2) placenta was removed manually by the surgeon’s hand introduced into the uterine cavity and cleavage plane was created between the placenta and decidua basalis following which the placenta was grasped and removed. With the use of oxytocin by intravenous infusion 20 units after delivery of the baby in both groups. Results: Blood loss in spontaneous placental separation group was (881.67 ± 74.54) ml, but in manual placental separation group was (962.79 ± 116.11) ml, (p<0.01). Conclusion: Manual removal of the placenta only seems to be superior in saving the time taken to extract out placenta.