Prospective and well-designed studies, based on a well agreed internationally retained placenta definition, are needed in order to clarify this potential dramatic and life-threatening condition. Old and new data are not enough robust to draw firm conclusions. Previous estro-progestins therapy, morphological placental features (weight, shape, insertion of umbilical cord, implantation site), endometriosis, Assisted Reproductive Technologies, Apgar score are fascinating new proposal risk factors. Maternal age, previous cesarean sections, previous dilation and curettage, previous retained placenta, labor induction, resulted as the most recurrent, independent risk factors for retained placenta. The reported retained placenta prevalence ranged from 0.5 to 4.8%. Thirty-five studies met the inclusion criteria. All stages of the revision followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The included articles were screened to identify study design, number of enrolled patients and retained placenta risk factors investigated. Conference abstracts, untraceable articles and studies focused on morbidly adherent placenta were excluded. Observational studies about retained placenta risk factors published in English language were considered eligible. MethodsĪ systematic literature review for all original research articles published between 19 was performed. This analysis collected and analyzed all known risk factors related to this obstetric complication. The unpredictability of this condition makes difficult to develop predictive and preventive strategies to apply in clinical practice. Retained placenta represents a cause of maternal morbidity and mortality affecting 0.5–3% of all vaginal deliveries.
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