{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:04:10Z","timestamp":1767827050489,"version":"3.49.0"},"reference-count":8,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,5,25]],"date-time":"2004-05-25T00:00:00Z","timestamp":1085443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2004,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p><jats:italic>Objectives<\/jats:italic>: To compare the effect of manual removal and spontaneous delivery of placenta on postcesarean bleeding and endometritis. <jats:italic>Methods<\/jats:italic>: In this prospective study 400 pregnant women undergoing elective cesarean delivery were randomly assigned to two groups: spontaneous placental delivery (200 women) and manual placental delivery (200). No antibiotic prophylaxis was administered in either group. The significance of blood loss due to cesarean delivery was defined by a drop in hemoglobin concentration of more than 1 g\/dl 24 h after delivery in comparison with preoperative hemoglobin concentration. Endometritis was diagnosed in patients who developed clinical signs of fever and suprapubic tenderness 48 h after delivery. We analyzed the data using a <jats:italic>t<\/jats:italic>\u2010test. <jats:italic>Results<\/jats:italic>: The overall endometritis rate was 27%, in 40 women in the spontaneous placental delivery group (20%) and 68 women in the manual placental removal group (34%). There was a statistically significant difference between the two groups (<jats:italic>P<\/jats:italic>=0.001). Significant blood loss was experienced by 52 women (26%) in the spontaneous placental delivery group vs. 100 women (50%) in the manual placental delivery group. There was a statistically significant difference in blood loss between the two groups (<jats:italic>P<\/jats:italic>=0.000; RR=1.92). <jats:italic>Conclusion<\/jats:italic>: Endometritis and blood loss in cesarean delivery is increased by manual removal of the placenta compared with the spontaneous method of placental removal.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2003.11.001","type":"journal-article","created":{"date-parts":[[2004,5,30]],"date-time":"2004-05-30T20:55:21Z","timestamp":1085950521000},"page":"12-15","source":"Crossref","is-referenced-by-count":17,"title":["Manual removal or spontaneous placental delivery and postcesarean endometritis and bleeding"],"prefix":"10.1002","volume":"86","author":[{"given":"S","family":"Dehbashi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Honarvar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.H","family":"Fardi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,5,25]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-198602000-00021"},{"issue":"6","key":"e_1_2_5_3_2","first-page":"686","article-title":"Risk factors associated with post cesarean section febrile morbidity","volume":"49","author":"Green S.L","year":"1977","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199404000-00009"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(11)91717-7"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00359-2"},{"key":"e_1_2_5_7_2","first-page":"517","article-title":"Infectious morbidity, operative blood loss and length of the operative procedure after cesarean delivery by method of placental removal and site of uterine repair","volume":"181","author":"Magann E.F","year":"1995","journal-title":"Am Coll Surg"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016349709024581"},{"issue":"4","key":"e_1_2_5_9_2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/0029-7844(94)00436-H","article-title":"Associated of post\u2010cesarean delivery endometritis with colonization of the chorioamnion by Ureoplasma urealyticum","volume":"85","author":"Andrews W.W","year":"1995","journal-title":"Obstet Gynecol"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S002072920300482X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S002072920300482X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2003.11.001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2003.11.001","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.ijgo.2003.11.001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T08:11:53Z","timestamp":1696407113000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1016\/j.ijgo.2003.11.001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,5,25]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2004,7]]}},"alternative-id":["10.1016\/j.ijgo.2003.11.001"],"URL":"https:\/\/doi.org\/10.1016\/j.ijgo.2003.11.001","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,5,25]]}}}