Published online Aug 10, 2014. doi: 10.5317/wjog.v3.i3.124
Revised: June 6, 2014
Accepted: July 12, 2014
Published online: August 10, 2014
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 retro-placental 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 intra-umbilical 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 total volume of at least 40 mL while preparing for transfer to a tertiary center or theatre may result in spontaneous expulsion of the placenta.
Core tip: Retained placenta is a known cause of post-partum haemorrhage and maternal mortality. The incidence of retained placenta had increased all over the world, which is more common in developed countries. Manual removal of the placenta has been the treatment of choice. However, it is a surgical intervention requiring anaesthesia with potential risk and complication. This manuscript reviews various methods that had been reported in the management of retained placenta.