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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 12, Issue 3, October 2014 pp 468-470
Do spontaneous separation of placenta reduce blood loss during caesarean delivery?
Shivamurthy H M1, Durgadas Asaranna2, Giridhar S A3, Ashwini Konin3, Jyotsna R Himgire4
1Professor and Unit Head, 3Postgraduates, JJM Medical College, Davanagere, Karnataka, INDIA.
2Associate Professor, Siddhartha Medical College, Tumkur, Karnataka, INDIA.
4Assistant Prfessor, Bidar Institute of Medical Sciences, Bidar, Karnataka, INDIA.
Background: Blood loss during a caesarean section is of great concern for the surgeon, especially in an anaemic patient and where facilities are not available for blood transfusion especially at the peripheral hospitals. Also majority of our pregnant women (nearly 80%) are anaemic. Again there is a lot of demand for blood transfusion due to non-comparable conditions like APH, PPH etc which may further lessen the availability of blood for transfusion. Such being the situation the technique of bloodless caesarean proves to be a boon in our setup .So also blood transfusion has its own complications. Objectives: To compare the blood loss after spontaneous separation of placenta with the blood loss associated with manual removal of placenta during caesarean section deliveries. Materials and Methods: In this study, estimation of blood loss in the placental delivery ,was done on 100 consecutive women undergoing caesarean section due to various indications excluding those who are likely to bleed by the virtue of their pathology like APH .Of the 100 cases 50 cases were managed by waiting for placental separation ,and alternative cases were managed by manual removal placenta without waiting for spontaneous separation .The blood loss was assessed by using preweighed cotton mops and weighing them again after the use to mop the blood loss. Care was taken to not allow the mixing of amniotic fluid and all the clots were weighed and computed for the loss of blood (by multiplying the weight of the clot by1.05) Results: Shapiro wilks test showed that the data was normally distributed, thus parametric test was employed. There was a statistical significance between the study and control groups for placental delivery interval, blood loss and drop in Hb levels at p < 0.05. There was no difference in the morbidity levels in study and control groups as shown by the Chi square test p (< 0.05) Conclusion: The spontaneous placental separation and delivery during caesarean section is associated with less blood loss than that of manual removal of placenta.