Manual Removal of the Placenta after Vaginal Delivery:

An Unsolved Problem in Obstetrics

Fiona Urner, Roland Zimmermann, and Alexander Krafft
Division of Obstetrics, Department of Obstetrics and Gynecology, University
Hospital Zurich, 8091 Zurich, Switzerland
Correspondence should be addressed to Alexander Kraf; alexander.kraf@usz.ch
Received 16 August 2013; Revised 12 January 2014; Accepted 30 January 2014;
Published 9 April 2014
Academic Editor: Antonio Farina
Copyright � 2014 Fiona Urner et al. Tis is an open access article distributed under
the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
Te third stage of labor is associated with considerable maternal morbidity and
mortality. Te major complication is postpartum
hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality
worldwide. Whereas in the event of PPH due
to atony of the uterus there exist numerous treatment guidelines; for the
management of retained placenta the general consensus
is more difcult to establish. Active management of the third stage of labour is
generally accepted as standard of care as already
its duration is contributing to the risk of PPH. Despite scant evidence it is
commonly advised that if the placenta has not been
expelled 30 minutes afer delivery, manuaakan berdampak buruk bagi perkembangan
bicara pada anak, proses belajar maupun kebiasaan seorang anak. Mortalitas akibat
komplikasi OMSK biasanya tinggi. Komplikasi intrakranial seperti abses otak dan
meningitis merupakan penyebab kematian terbesar pada pasien OMSK.1 Oleh karena itu,
diperlukan pemahaman yang lebih baik terkait faktor penyebab OMSK serta pencegahan
dan penanganannyal removal of the placenta should be ca