Acta clinica Croatica, Vol. 64. No. 3, 2025.
Original scientific paper
https://doi.org/10.20471/acc.2025.64.03.08
The Effect of Placenta Removal Method on Postpartum Leukocytosis – A Randomized Controlled Trial
Sevcan Arzu Arinkan
; Reproductive Medicine Center, Skane University Hospital, Malmö, Sweden
*
Hilal Serifoglu
; Department of Obstetrics and Gynecology, Haydarpasa Numune Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
* Corresponding author.
Abstract
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.
Keywords
Controlled cord traction; Endometritis; Leukocytosis; Placenta; Postpartum infection; Removal method
Hrčak ID:
342934
URI
Publication date:
30.9.2025.
Visits: 500 *