Table 3.
Patients with retained placenta with or without uterine atony
| Variables | Uterine atony (n = 81) | No uterine atony (n = 215) | p value |
|---|---|---|---|
| Outcome parameters | |||
| Δ-Hemoglobin (g/l) a | 55 (39–67.5) | 35 (22–47) | < 0.001 |
| MBL (ml) | 2000 (1500–2600) | 1100 (800–1600) | < 0.001 |
| PPH (≥ 500 ml) | 81 (100.0%) | 205 (95.4%) | 0.048 |
| Blood transfusion | 11 (13.6%) | 2 (0.9%) | < 0.001 |
| Risk factors for increased blood loss | |||
| Uterine myomas | 2 (2.5%) | 8 (3.7%) | 0.595 |
| BL due to maternal obstetric b injuries | 4 (4.9%) | 12 (5.6%) | 0.821 |
| Second stage labor (min) | 69 (21–127) | 60 (21–122) | 0.814 |
| Second stage labor > 2 h | 23 (28.4%) | 54 (25.1%) | 0.566 |
| Third stage of labor (min) | 61.5 (50–73.5) | 67 (59–77) | 0.010 |
| Operative vaginal delivery | 13 (16.1%) | 33 (15.4%) | 0.882 |
| Previous caesarean section | 7 (8.6%) | 9 (4.2%) | 0.131 |
| Morbidly adherent placenta | 14 (17.3%) | 28 (13.0%) | 0.349 |
| Feto-maternal characteristics | |||
| Fetal weight (g) | 3240 (2900–3690) | 3220 (2760–3570) | 0.264 |
| Fetal head circumference (cm) | 34.5 (33.5–36) | 34.5 (33–35.5) | 0.307 |
| GA (d) | 278 (269–284) | 276 (262–284) | 0.381 |
| Maternal body mass index first trimester (kg/m2) | 21.3 (20.1–24.7) | 21.5 (19.8–24.5) | 0.957 |
| Maternal age (y) | 34.5 (31.7–37.2) | 33.6 (30.2–36.5) | 0.248 |
| Multiple fetus pregnancy | 3 (3.7%) | 6 (2.8%) | 0.683 |
| Multiparity | 38 (46.9%) | 91 (42.3%) | 0.478 |
| Primiparity | 43 (53.1%) | 124 (57.7%) | 0.522 |
| Fetal weight ≥ 4000 g | 4 (4.9%) | 12 (5.6%) | 0.827 |
| Induction of labor | 28 (34.6%) | 57 (26.5%) | 0.172 |
| Hypertensive disordersc | 6 (7.4%) | 6 (2.8%) | 0.073 |
| Anesthetic characteristics | |||
| General anesthesia | 32 (39.5%) | 20 (9.3%) | < 0.001 |
| Regional anesthesia pp | 26 (32.1%) | 110 (51.2%) | 0.003 |
| Admission to ICU postpartum | 5 (6.2%) | 1 (0.5%) | 0.002 |
Data are median (interquartile range) or n (%)
MBL measured blood loss; PPH postpartum hemorrhage; GA gestational age; pp postpartum; EDA epidural anesthesia; ICU intensive care unit
aΔ-Hb (g/l): difference in hemoglobin levels antepartum minus postpartum
bMaternal obstetric injuries: cervical, vaginal or perineal tears
cHypertensive disorders include: prior existing hypertension, gestational induced hypertension, preeclampsia and HELLP