Retained Placenta

A placenta that fails to be expelled after BIRTH of the FETUS. A PLACENTA is retained when the UTERUS fails to contract after the delivery of its content, or when the placenta is abnormally attached to the MYOMETRIUM.

Also Known As:

Networked: 321 relevant articles (21 outcomes, 47 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hemorrhage
2.	Infection
3.	Pain (Aches)
4.	Mastitis
5.	Endometritis

Experts

1.	Kankofer, M: 5 articles (02/2004 - 01/2001)
2.	Duffield, T F: 4 articles (10/2012 - 03/2004)
3.	Lotgering, Fred K: 3 articles (09/2013 - 02/2006)
4.	van Beekhuizen, Heleen J: 3 articles (09/2013 - 02/2006)
5.	Leslie, K E: 3 articles (10/2012 - 03/2004)
6.	Kindahl, H: 3 articles (12/2011 - 10/2001)
7.	Abdel-Aleem, Mahmoud A: 2 articles (01/2015 - 01/2011)
8.	Abdel-Aleem, Hany: 2 articles (01/2015 - 01/2011)
9.	Shaaban, Omar M: 2 articles (01/2015 - 01/2011)
10.	Wang, Lei: 2 articles (03/2014 - 02/2014)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Retained Placenta:

1.	Oxytocin (Pitocin)FDA LinkGeneric 11/01/2011 - "Intra-umbilical vein oxytocin injection is clinically effective for the management of a retained placenta." 01/01/2013 - "Efficacy of intra-umbilical oxytocin in the management of retained placenta: a randomized controlled trial." 01/01/2013 - "This was a single-center randomized controlled trial incorporating 58 women with retained placenta of more than 30 min, equally distributed into two study arms of intra-umbilical injection of oxytocin (50 IU oxytocin diluted with normal saline [NS] to a total volume 30 mL) and intra-umbilical injection of NS (30 mL). " 01/09/2010 - "Umbilical vein oxytocin for the treatment of retained placenta (Release Study): a double-blind, randomised controlled trial." 10/01/2005 - "The Release Trial: a randomised controlled trial of umbilical vein oxytocin versus placebo for the treatment of retained placenta."
2.	Misoprostol (Cytotec)FDA LinkGeneric 01/01/2014 - "Umbilical vein injection of misoprostol is an effective treatment for retained placenta, and reduces the volume of vaginal blood loss with few adverse effects. " 12/01/2001 - "Our study demonstrated that misoprostol per rectum is a safe and effective technique and may be a useful alternative to manual removal of retained placentas." 01/01/2014 - "This study evaluated the effectiveness of umbilical vein injection of misoprostol for the treatment of retained placenta in a hospital setting. " 01/01/2014 - "Umbilical vein injection of misoprostol versus normal saline for the treatment of retained placenta: intrapartum placebo-controlled trial." 04/01/2013 - "No reduction of manual removal after misoprostol for retained placenta: a double-blind, randomized trial."
3.	Nitroglycerin (Dynamite)FDA LinkGeneric 02/01/1997 - "A retrospective chart review of all anaesthesia consultations for retained placenta at 28 weeks' gestational age or more was performed to determine the safety and efficacy of intravenous glyceryl trinitrate therapy in the management of retained placenta. " 01/01/2008 - "Sublingual nitroglycerin seems to be effective in the management of retained placenta." 12/01/2005 - "The aim of the study was to investigate the effect of sublingual nitroglycerin for management of retained placenta and to assess possible adverse effects of the treatment. " 01/01/2015 - "Nitroglycerin for management of retained placenta." 01/01/2012 - "Nitroglycerin for management of retained placenta: a multicenter study."
4.	Vitamin EFDA LinkGeneric 06/01/1987 - "Incidence of retained placenta (22.1%) was not reduced by Se in combination with vitamin E injection or intraruminal Se pellet nor were other measures of reproduction improved for cows fed a prepartum diet adequate in Se. " 08/15/1997 - "Parenteral administration of a single injection of vitamin E before parturition may decrease the incidence of retained placenta and metritis in dairy cows but will increase serum concentrations for 7 to 14 days after administration." 08/15/1997 - "Administration of vitamin E significantly decreased the incidence of retained placenta and metritis (13/204 [6.4%] and 8/204: [3.9%], respectively, for the vitamin E-treated group; 27/216 [12.5%] and 19/ 216 [8.8%], respectively, for the untreated group) but did not affect the incidence of clinical mastitis. " 04/01/2008 - "Supplementation of vitamin E and/or Se has reduced the incidence of mastitis and retained placenta, and reduced duration of clinical symptoms of mastitis in some experiments. " 08/01/1985 - "In a series of experiments over 3 yr, relatively low doses of selenium and vitamin E were injected intramuscularly 3 wk prepartum to pregnant Israeli-Holstein dairy cows in a high-producing herd (9000 kg milk/yr) with a history of retained placenta in 17% of the primiparous and 28% of the multiparous animals, as recorded for the 12 mo preceding the study. "
5.	DinoprostIBA 07/15/2007 - "Cervical diameter in relation to uterine and cervical EMG activity in early postpartum dairy cows with retained placentas after PGF2alpha induced calving." 10/01/1999 - "All aborted ewes had retained placentas (P < or = 0.05) except one ewe in the TR + PGF2alpha, treatment group. " 01/01/1996 - "We suggest that intraumbilical vein injection of prostaglandin F2 alpha might be a beneficial, non-surgical method for treating retained placenta. " 01/01/1996 - "Intraumbilical vein injection of prostaglandin F2 alpha in retained placenta." 09/01/1992 - "In the dairy cow, retained placenta could be due to a PgF2alpha or an energy deficiency at calving. "
6.	Oxytetracycline (Terramycin)FDA Link 04/01/1966 - "A study of the action of terramycin on the bacterial flora of the uterus in cattle following retained placenta." 02/01/2002 - "Oxytetracycline treatment during the period immediately after parturition before placental shedding might influence the PG-metabolite profile and suggests a bacteriological contribution to the high levels of PG-metabolite seen during the first 2 weeks pp in cows with retained placenta. " 10/01/2001 - "It was concluded that early oxytetracycline treatment of retained fetal membranes in the cow did not shorten the uterine involution or uterine infection but it did slow down the detachment process of the retained placenta. " 02/01/2014 - "The herbal tincture was extracted from a combination of Herba Leonuri, Angelicae Sinensis Radix, Flos Carthami, Myrrha and Rhizoma Cyperi by percolation with 70% ethanol to a concentration of 0.5g crude herb/ml. Cows diagnosed with retained placenta (n=48) were randomly divided into one of two treatment groups (A and B), with animals in group A (n=26) receiving herbal tincture orally, and cows in group B (n=22) receiving oxytetracycline infusion into the uterus. " 04/01/1996 - "Evaluation of injections of collagenase and oxytetracycline via the umbilical artery as treatment for retained placenta in cattle."
7.	Sodium Chloride (Saline Solution)FDA LinkGeneric 01/01/2001 - "Umbilical vein injection of saline solution plus oxytocin appears to be effective in the management of retained placenta. " 01/01/2011 - "To assess the use of umbilical vein injection (UVI) of saline solution alone or with oxytocin in comparison either with expectant management or with an alternative solution or other uterotonic agent for retained placenta. " 01/01/2001 - "The objective of this review was to assess the use of umbilical vein injection of saline solution alone or with oxytocin in comparison either with expectant management or with an alternative solution or other uterotonic agent for retained placenta. " 05/01/1991 - "In a multicenter randomized controlled trial involving 220 women with retained placenta no beneficial effects could be established of intraumbilical vein administration of 10 IU of oxytocin in 20 ml of saline solution. " 02/01/2011 - "In this randomized controlled study, 40 women with a placenta retained for 30 minutes received intravenously 200 μg of nitroglycerin or a normal saline solution before umbilical cord traction was initiated. "
8.	SeleniumIBA 12/01/2006 - "Retained placenta can be reduced by prevention of hypocalcaemia and also adequate selenium status of the dairy cow. " 08/01/1985 - "Dosage, timing, mechanism, and interactions of selenium with other factors in reducing the incidence of retained placenta need clarification." 08/01/1985 - "Doses of selenium ranging from 2.3 to 23.0 mg reduced the incidence of retained placenta in 186 primiparous and in 428 multiparous to 7 and 15%, which was half of that of controls. " 01/01/1981 - "[Comparative studies of selenium levels in serum, placenta, myometrium and milk of cows with or without retained placenta]." 08/01/1985 - "In a series of experiments over 3 yr, relatively low doses of selenium and vitamin E were injected intramuscularly 3 wk prepartum to pregnant Israeli-Holstein dairy cows in a high-producing herd (9000 kg milk/yr) with a history of retained placenta in 17% of the primiparous and 28% of the multiparous animals, as recorded for the 12 mo preceding the study. "
9.	Collagenases (Collagenase)FDA Link 03/01/2010 - "Collagenase injected into the umbilical arteries of retained placentas specifically targets the lack of placentome proteolysis and might enhance placental release. " 07/01/1998 - "The potential of collagenase as a new therapy for separation of human retained placenta: hydrolytic potency on human, equine and bovine placentae." 07/01/1998 - "Intraplacental injections of collagenase via umbilical cord arteries may help to detach retained placenta in women as it does in mares and cows." 11/01/1997 - "Prevention of retained placenta by injection of collagenase into umbilical arteries of calves delivered by cesarean section: a tolerance study." 08/01/1993 - "Successful treatment of retained placenta with umbilical cord injections of collagenase in cows."
10.	Dexamethasone (Maxidex)FDA LinkGeneric 09/15/2011 - "The study showed that the chemotactic activity of cotyledons for mononuclear leukocytes was lower (P < 0.001) in cotyledons obtained from retained placenta cows in which parturition was induced with dexamethasone compared to the chemotactic activity of cotyledons obtained from spontaneously calving non-retained placenta cows, whereas the chemotactic activity of cotyledons obtained from induced non-retained placenta cows was not lower (P = 0.10) than the chemotactic activity of cotyledons obtained from spontaneously calving non-retained placenta cows. " 09/15/2011 - "Cotyledons were collected from spontaneously calving non-retained placenta cows and from dexamethasone induced non-retained placenta and retained placenta cows. " 09/15/2011 - "Chemotactic activity of cotyledons for mononuclear leukocytes related to occurrence of retained placenta in dexamethasone induced parturition in cattle." 11/01/1996 - "In conclusion, treatment with pRelaxin alone failed to induce parturition or, when combined with dexamethasone, to reduce the incidence of retained placentas." 11/01/1996 - "The incidence of retained placentas in heifers treated only with dexamethasone (27.3%) was not reduced by concomitant treatment with pRelaxin (35.3%). "

Therapies and Procedures

1.	Injections 12/01/2006 - "The incidence of additional oxytocic injections, postpartum haemorrhage (blood loss > or = 500 ml) and retained placenta were also similar. " 07/01/1998 - "Intraplacental injections of collagenase via umbilical cord arteries may help to detach retained placenta in women as it does in mares and cows." 08/01/1993 - "Successful treatment of retained placenta with umbilical cord injections of collagenase in cows." 01/01/1984 - "Supplementation of vitamin E was required in addition to selenium for prevention of retained placenta of cows fed stored ensiled forage, and prepartum selenium injections were effective for reducing the incidence of metritis and cystic ovaries during the early postpartum period." 04/01/1996 - "Evaluation of injections of collagenase and oxytetracycline via the umbilical artery as treatment for retained placenta in cattle."
2.	Hysterectomy 12/18/2015 - "With the placenta retained within the uterus, a total hysterectomy was performed. " 07/01/2014 - "A video of peripartum emergency subtotal hysterectomy in a patient with retained placenta and suspicion of accretism is presented. " 07/01/2010 - "Hysterectomy was needed in one woman with retained placenta. " 04/01/2010 - "With the placenta retained within the uterus, a total hysterectomy was performed in the usual fashion. " 02/01/2003 - "However, retained placenta poses a serious risk, even after months, and secondary hysterectomy should be performed as an elective procedure after embolization."
3.	Dilatation and Curettage (D&C) 07/01/2008 - "Independent risk factors associated with retained placenta include non-use of antenatal care (odds-ratio [OR] 22.71, 95 percent confidence interval [CI] 10.5-49.12, p-value is less than 0.000), previous retained placenta (OR 15.22, 95 percent CI 3.30-70.19, p-value is less than 0.000), previous caesarean section (OR 12.00, 95 percent CI 2.05-70.19, p-value is less than 0.006), maternal age 35 years or more (OR 7.10, 95 percent CI 1.5-32.40, p-values is less than 0.012), grand multiparity (OR 6.63, 95 percent CI 1.88-23.40, p-value is less than 0.003), previous dilatation and curettage (OR 4.44, 95 percent CI 1.69-11.63, p-value is less than 0.002), preterm delivery (OR 3.12, 95 percent CI 1.12-8.68, p-value is less than 0.029) and placenta weight less than 501 g (OR 2.91, 95 percent CI 1.34-6.32, p-value is less than 0.007). " 03/01/2006 - "Evacuation of the retained placenta resulted in septic shock, which occurred immediately after dilatation and curettage. " 11/01/2005 - "Secondary outcome measures were the rate of dilatation and curettage (D&C) for retained placenta and the rates of fever and gastrointestinal complications. " 10/01/2003 - "An hour after delivery the patient began complaining of syncope; at this time bleeding was greater than expected and the obstetrician decided a dilatation and curettage for retained placenta was necessary. " 11/01/2005 - "The rate of retained placenta requiring D&C was significantly greater in the PGF2alpha group (22.4% vs. 3.4%, P = 0.002). "
4.	Anesthesia 01/01/1993 - "Nubain proved effective in stabilizing patients' condition during intra-amniotic instillation of prostaglandin, effectively relieved uterine pain during the myometrial contractility period, prevented the occurrence of prostaglandin-related side-effects, and provided simple and good anesthesia during instrumental removal of the already detached but retained placenta." 12/01/2004 - "While established risk factors can be identified among risk factors of PPH during labor after multivariate analysis: prolonged labor, oxytocin stimulation of labor, cesarean section, instrumental delivery, genital lacerations and episiotomy, prolonged third stage of labor, retained placenta; other risk factors are still uncertain: induction of labor, hyperthermia or chorioamniotitis, analgesia or anesthesia, macrosomia, various cesarean section techniques. "
5.	Cesarean Section (Caesarean Section) 06/01/2014 - "Modelling demonstrated how prepregnancy- and pregnancy-acquired factors may be mediated through intrapartum events, including caesarean section, elective (aOR 24.4, 95% CI 5.53-108.00) or emergency (aOR 40.5, 95% CI 16.30-101.00), and retained placenta (aOR 21.3, 95% CI 8.31-54.7). " 01/01/2014 - "Our report shows an increased risk for retained placenta in women previously delivered by caesarean section, a finding that should be considered in discussions of mode of delivery." 01/01/2014 - "The risk of retained placenta at second delivery was estimated for women with a first delivery by caesarean section (n = 19,458), using women with a first vaginal delivery as reference (n = 239,150). " 01/01/2014 - "To evaluate whether women with a caesarean section at their first delivery have an increased risk of retained placenta at their second delivery. " 01/01/2014 - "Risk of retained placenta in women previously delivered by caesarean section: a population-based cohort study."