THE EFFECT OF PLACENTA REMOVAL METHOD ON POSTPARTUM LEUKOCYTOSIS – A RANDOMIZED CONTROLLED TRIAL UTJECAJ METODE UKLANJANJA PLACENTE NA POSLIJEPOROĐAJNU LEUKOCITOZU – RANDOMIZIRANO KONTROLIRANO ISTRAŽIVANJE
Acta Clinica Croatica, cilt.64, sa.3, ss.477-483, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 64 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.20471/acc.2025.64.03.08
- Dergi Adı: Acta Clinica Croatica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
- Sayfa Sayıları: ss.477-483
- Anahtar Kelimeler: Controlled cord traction, Endometritis, Leukocytosis, Placenta, Postpartum infection, Removal method
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
The rate of cesarean section (CS) as one of the common major surgeries has been increasing every year. Standardizing of surgical technique will improve outcomes and decrease postpartum infections. The purpose of this study was to investigate whether there was an association between the placental removal method and mean postpartum white blood cell (WBC) counts. This prospective randomized controlled study included 279 singleton pregnancies having CS. Women were randomized into two groups with manual placenta removal and spontaneous delivery with controlled cord traction. There was no significant difference between the groups regarding the mean temperatures (p>0.05). The mean WBC and neutrophil counts (postoperative day 1 and 2) were found to be higher in manual group. However, these differences were not significant (p>0.05). The rate of wound infection was 2.11% in controlled cord traction group and 1.45% in manual group. The rate of endometritis was 0.35% in all cases. A negative correlation was found between the mean WBC count on postoperative day 2 and gravidity (p=0.001; r=-0.195). There also was a negative correlation between the mean WBC count on postoperative day 2 and number of CS (p=0.001; r=-0.200). In conclusion, manual removal of placenta slightly increased postpartum WBC and neutrophil counts. If the method of placenta removal increases leukocyte count, it may not be substantial enough to result in an infection.