Retained Placenta in a Tertiary Nigerian Centre: Incidence, Risk Factors, and Maternal Outcomes from a Five-Year Retrospective Study (2018-2022) at Esuth-Parklane

Abstract

Background: Retained placenta is a significant complication of the third stage of labour and an important cause of postpartum haemorrhage and maternal morbidity in low-resource settings. Despite improvements in emergency obstetric care, delayed presentation and unbooked status remain common challenges in South-East Nigeria.
Aim: To determine the incidence, risk factors, clinical presentation, management modalities, and maternal outcomes of retained placenta at Enugu State University Teaching Hospital (ESUTH), Parklane, Enugu, over a five-year period.
Methods: This was a retrospective descriptive study of women managed for retained placenta at or beyond 28 weeks of gestation between January 2018 and December 2022. Case records were retrieved from the labour ward, gynaecology emergency unit, and medical records department. Relevant socio-demographic, obstetric, clinical, and outcome variables were extracted and analyzed using SPSS version 26.0. Results were presented using descriptive statistics.
Results: A total of 112 cases of retained placenta were identified during the study period. Most affected women were aged 20–30 years (48.2%) and multiparous (58.1%). The majority were unbooked (82.1%) and delivered outside the study centre, mainly at home or with traditional birth attendants (59.8%). Active haemorrhage was present in 30.4% at presentation. Manual removal of the placenta was the predominant treatment modality (65.2%), and 43.8% required blood transfusion. Although 89.3% were discharged without complications, 10.7% experienced morbidity. No maternal mortality was recorded.
Conclusion: Retained placenta remains a clinically significant third-stage complication at ESUTH, particularly among unbooked and non-institutionally delivered women. Improved antenatal care utilization, skilled birth attendance, and strengthened referral systems are essential to reducing associated maternal morbidity.