The Effect of Placental Spontaneous Delivery versus Manual Removal on Blood Loss during Cesarean Section: A Comparative Study

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Faculty of medicine, Ain Shams University

2 Department of Obstetrics and Gynecology, faculty of Medicine, Ain Shams University

3 Faculty of medicine Ain shams University

10.21608/ebwhj.2025.356782.1422

Abstract

Objective: To compare manual removal versus spontaneous delivery of the placenta at CS regarding blood loss.
Study Design: Randomized prospective comparative study.
Setting: Ain Shams university maternity hospital from June 2022 till December 2022
Methods: A total of 200 women who were planned for elective cesarean section were randomized into 2 groups: group 1 assigned for spontaneous placental delivery and group 2 in which the placenta was manually removed. Intraoperative blood loss, operative time and postoperative hemoglobin drop were evaluated.
Results: Group 2 had significantly higher blood loss (397.0±186.5 vs 245.5±113.3 ml) and more need for ecbolics when compared to group 1 with no significant difference between both groups in operative time.
Conclusion: Spontaneous placental separation during cesarean section results in less blood loss than manual placental separation without significant prolongation of operative time.

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