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

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 2022Methods: 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.