title: No reduction of manual removal after misoprostol for retained placenta: a double-blind, randomized trial.
abstract: OBJECTIVE
  To test the effect of 800 μg of misoprostol orally on the prevention of manual removal of retained placenta.
  
  
  METHODS
  Multicenter, double-blinded, placebo-controlled, randomized trial.
  
  
  METHODS
  One university and one non-university teaching hospital in the Netherlands.
  
  
  METHODS
  99 women with retained placenta (longer than 60 min after childbirth) in the absence of postpartum hemorrhage.
  
  
  METHODS
  Eligible women were administered either 800 μg of misoprostol or placebo orally.
  
  
  METHODS
  Number of manual removals of retained placenta and amount of blood loss.
  
  
  RESULTS
  Manual removal of retained placenta was performed in 50% of the women who received misoprostol and in 55% who received placebo (relative risk 0.91, 95% confidence interval 0.62-1.34). No difference in the amount of blood loss (970 vs. 1120 mL; p = 0.34) was observed between the two groups.
  
  
  CONCLUSIONS
  Administration of 800 μg of oral misoprostol, one hour after childbirth, does not seem to reduce the number of manual removals of retained placentas. The time elapsing results in the delivery of 50% of the retained placentas at the expense of an increased risk of postpartum hemorrhage.
authors.affiliation: Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands. gielvs@gmail.com
authors.forename: Giel
authors.initials: G
authors.lastname: van Stralen
authors.forename: Marieke
authors.initials: M
authors.lastname: Veenhof
authors.forename: Cas
authors.initials: C
authors.lastname: Holleboom
authors.forename: Jos
authors.initials: J
authors.lastname: van Roosmalen
mesh_terms: D000284:Administration, Oral; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D009426:Netherlands; D010120:Oxytocics / Q000008:administration & dosage*; D018457:Placenta, Retained / Q000188:drug therapy* / Q000628:therapy; D011181:Postnatal Care / Q000379:methods*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D016595:Misoprostol