Akol, Achier Deng
(2019)
The clinical importance of retained placenta subtypes.
PhD thesis, University of Liverpool.
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Abstract
In the UK, a placenta is considered retained if it is not delivered within 30 minutes of active and 60 minutes of expectant management of the third stage of labour (NICE, 2014). If a retained placenta (RP) is not treated, it may lead to maternal death due to postpartum haemorrhage or sepsis. Currently, the standard treatment is manual removal of the placenta. This is associated with anaesthetic and surgical risks compared to medical alternatives. Unfortunately, these medical alternatives are not well investigated. This is partly because of current inability to rapidly and accurately diagnose the three known subtypes of the retained placenta prior to the theatre on the labour ward. These subtypes are defined as: placenta adherens, when there is failed contraction of the myometrium behind the placenta; partial accreta, when there is a small area of accreta preventing detachment; and trapped placenta, where a detached placenta is trapped behind a closed cervix. This study explored whether these subtypes can be diagnosed prior to surgery, whether the type is important and whether hydrogen sulphide expression is involved in the pathology of RP. First, a retrospective epidemiological cohort study of Liverpool women ... (continues)
| Item Type: | Thesis (PhD) |
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| Divisions: | Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences > School of Medicine |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 14 Aug 2020 07:41 |
| Last Modified: | 08 Feb 2025 02:08 |
| DOI: | 10.17638/03087418 |
| Supervisors: |
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| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3087418 |
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