title: Rectal misoprostol in management of retained placenta: a contradictory result.
abstract: BACKGROUND
  Retained placenta is one of the common problems in obstetric practice. The most common procedure to manage cases with retained placenta is manual removal of placenta (MROP) under general anesthesia. Recent data indicates that misoprostol may be helpful in decreasing the rate of MROP.
  
  
  OBJECTIVE
  To assess the efficacy of rectal misoprostol in women with delayed placental separation.
  
  
  METHODS
  A descriptive, retrospective cohort was conducted. All pregnant women with retained placenta longer than 30 minutes after fetal delivery, either in second or third trimester that received 800 mcg rectal misoprostol were included in the present study. Successful treatment was defined as spontaneous placental expulsion within 30 minutes after rectal misoprostol administration.
  
  
  RESULTS
  The rate of spontaneous placental expulsion within 30 minutes after misoprostol administration was very low, only three out of 20 cases (15%).
  
  
  CONCLUSIONS
  High dose rectal misoprostol does not give a promising result in cases of retained placenta. It is ineffective to facilitate placental separation in cases of retained placenta and does not seem to decrease the rate of MROP.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. spongsat@mail.med.cmu.ac.th
authors.forename: Saipin
authors.initials: S
authors.lastname: Pongsatha
authors.forename: Theera
authors.initials: T
authors.lastname: Tongsong
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000285:Administration, Rectal; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D016595:Misoprostol / Q000627:therapeutic use*; D018457:Placenta, Retained / Q000188:drug therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol