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Retained placenta: Do we have any option?

World Journal of Obstetrics and Gynecology 2014年第3期3卷 124-129页

作者： Pei Shan Lim Nor Azlin Mohamed Ismail Nur Azurah Abd Ghani nirmala chandralega kampan Aqmar Suraya Sulaiman Beng Kwang Ng Kah Teik Chew Abdul Kadir Abdul Karim Muhammad Abdul Jamil Mohd Yassin Department of Obstetrics and Gynecology Faculty of Medicine Universiti Kebangsaan Malaysia

Retained placenta is a known cause of post-partum haemorrhage and maternal mortality. A recent systemic review has confirmed that the incidence of retained placenta had increased all over the world, which is more common in developed countries. Failure of retroplacental myometrium contraction is the main cause of retained placenta. Maternal age greater than 35 years, grandmultipara, preterm labor, history of previous retained placenta, and caesarean section were the risk factors for retained placenta. Manual removal of the placenta has been the treatment of choice. Attempts had been made by clinician and researchers to find a safe, effective and reliable method to avoid the need for surgical intervention. The efficacy and safety of prostaglandin, nitroglycerin or acupuncture in the management of retained placenta are yet to be further evaluated. Nonetheless, till date only intraumbilical vein oxytocin has been studied extensively but with varied success. More randomized clinical trials are needed to address this issue. However, if immediate manual placenta removal service is unavailable, a trial of intra-umbilical vein oxytocin 100 IU at a totalvolume of at least 40 m L while preparing for transfer to a tertiary center or theatre may result in spontaneous expulsion of the placenta.

关键词： Retained placenta Manual removal of the placenta Intra-umbilical vein Oxytocin Prostaglandin Misoprostol Carboprost Acupuncture

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