Consecutive intra-umbilical vein injection of misoprostol and intravenous sulprostone in the management of retained placenta (RP). The general accepted treatment of RP is manual removal of the placenta (MRP), but medical intervention protocols were suggested. We evaluate a protocol of using intra-umbilical vein injection of misoprostol followed, if necessary, by intravenous sulprostone. A reduction in the need for MRP and less blood loss was expected. Cohort A (1 January 2007 to 31 September 2008), managed by an expectative protocol including active management of the third stage of labor and if necessary MRP performed 60 min after birth of the baby, was compared with cohort B (1 April 2009 to 31 December 2010) managed by medical intervention protocol. This protocol consisted of intra-umbilical vein injection of misoprostol and if not successful, 250 mu g of sulprostone was given intravenously in 30 min. All vaginal deliveries after 24 weeks of gestation, with RP after 20 min and blood loss results.
Notten, F., Meertens, L., Wissink, B., & Scheepers, H. C. J. (2014). Consecutive intra-umbilical vein injection of misoprostol and intravenous sulprostone in the management of retained placenta. Archives of Gynecology and Obstetrics, 289(1), 35-40. https://doi.org/10.1007/s00404-013-2919-4