Umbilical vein oxytocin in the management of retained placenta: an alternative to manual removal of placenta?
OBJECTIVE
Retained placenta is potentially life threatening due to possible complications associated with manual removal. Our aim was to determine whether umbilical vein injection of oxytocin in saline reduces the need for manual removal of placenta.


METHODS
This was a randomised controlled trial conducted at a tertiary hospital from December 2002 to March 2004. A total of 61 women delivering singletons, who had no sign of placental separation 20 min after vaginal delivery, were randomised to receive either intra-umbilical oxytocin 100 IU diluted in 30 ml of saline or controlled cord traction only. Manual removal was done if the placenta was not expelled in another 30 min in both arms.


RESULTS
There was a significant reduction in the rate of subsequent manual removal of placenta (30 vs. 67.7%, p < 0.05), incidence of uterine atony (3.3 vs. 25.8%, p < 0.05) and the need for uterotonic agents (33.3 vs. 64.5%, p < 0.05) in the oxytocin group when compared with the control group. No significant differences were found in the need for blood transfusion, uterine curettage, incidence of postpartum haemorrhage and haemoglobin level reduction.


CONCLUSIONS
Intra-umbilical vein oxytocin injection is clinically effective for the management of a retained placenta.
Department of O&G, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaakob Latif, 56000 Cheras, Kuala Lumpur, Malaysia. pslim@ppukm.ukm.my
Pei Shan
PS
Lim
Surinder
S
Singh
Alice
A
Lee
Muhammad Abdul Jamil
MA
Muhammad Yassin
D000328:Adult; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D010121:Oxytocin / Q000627:therapeutic use*; D018457:Placenta, Retained / Q000188:drug therapy* / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D016896:Treatment Outcome; D014471:Umbilical Veins / Q000187:drug effects; D014593:Uterine Inertia / Q000188:drug therapy
D010121:Oxytocin