Zmora I, et al. - Researchers performed ten years retrospective register-based cohort study of vaginal deliveries, comparing women with 3^rd stage of labor removal of placental fragments (3^rd SRPF) n = 3297 (exposed) with those without n = 97,888 (non exposed) regarding risk factors and complications. For 3^rd SRPF procedure, reproductive technologies, preterm delivery, preeclampsia, multiple previous early pregnancy loss (>3), VBAC and epidural analgesia were the risk factors. In the 3^rd SRPF vs the control group, early complications were: puerperal fever 1.1% vs 0.3%, blood transfusion 9.0% vs 0.5%, prolonged maternal hospitalization 21.0% vs 11.4%; puerperal readmission was 0.819% vs 0.315%. In this work, 3^rd SRPF had significantly higher rates of late complications vs controls (retained placenta and hysteroscopy / D&C rates were: 40.7% vs 7.1%, 14.8% vs 3.6% and 48.1% vs 18.2%, respectively).