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Retained Placenta

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1. Umbilical Vein Injection of Misoprostol for the Management of Retained Placenta: A Review of Clinical Effectiveness and Guidelines

Umbilical Vein Injection of Misoprostol for the Management of Retained Placenta: A Review of Clinical Effectiveness and Guidelines Umbilical Vein Injection of Misoprostol for the Management of Retained Placenta: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Umbilical Vein Injection of Misoprostol for the Management of Retained Placenta: A Review of Clinical Effectiveness and Guidelines Umbilical Vein Injection of Misoprostol for the Management (...) of Retained Placenta: A Review of Clinical Effectiveness and Guidelines Published on: January 23, 2017 Project Number: RC0842-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of umbilical vein injections with misoprostol for the management of retained placenta? What are the evidence-based guidelines regarding umbilical vein injections with misoprostol for the management of retained placenta? Key Message One

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Nitroglycerin for management of retained placenta. (PubMed)

Nitroglycerin for management of retained placenta. Retained placenta affects 0.5% to 3% of women following delivery, with considerable morbidity if left untreated. Use of nitroglycerin (NTG), either alone or in combination with uterotonics, may be of value to minimise the need for manual removal of the placenta in theatre under anaesthesia.To evaluate the benefits and harms of NTG as a tocolytic, either alone or in addition to uterotonics, in the management of retained placenta.We searched (...) the Cochrane Pregnancy and Childbirth Group's Trials Register (14 January 2015), reference lists of retrieved studies and contacted experts in the field.Any adequately randomised controlled trial (RCT) comparing the use of NTG, either alone or in combination with uterotonics, with no intervention or with other interventions in the management of retained placenta. All women having a vaginal delivery with a retained placenta, regardless of the management of the third stage of labour (expectant or active). We

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2015 Cochrane

3. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. (PubMed)

Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. Retained placenta is a potentially life-threatening condition because of its association with postpartum hemorrhage. Manual removal of placenta increases the likelihood of bacterial contamination in the uterine cavity.To compare the effectiveness and side-effects of routine antibiotic use for manual removal of placenta in vaginal birth in women who received antibiotic prophylaxis and those who did (...) not and to identify the appropriate regimen of antibiotic prophylaxis for this procedure.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014).All randomized controlled trials comparing antibiotic prophylaxis and placebo or non antibiotic use to prevent endometritis after manual removal of placenta in vaginal birth.There are no included trials. In future updates, if we identify eligible trials, two review authors will independently assess trial quality and extract dataNo studies

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2014 Cochrane

4. Extracellular matrix proteins in healthy and retained placentas, comparing hemochorial and synepitheliochorial placentas. (PubMed)

Extracellular matrix proteins in healthy and retained placentas, comparing hemochorial and synepitheliochorial placentas. The placenta expresses structural and biologically active proteins. Their synthesis is mainly regulated by genomic or nongenomic signals and modulated by hormones. These protein profiles are altered during different stages of pregnancy. The biological properties of extracellular matrix (ECM) proteins were defined and described in a number of tissues including placenta (...) . These properties enable them to be the main players in the processes of attachment or invasion into the endometrium during initial placenta formation and its timely separation after delivery and detachment. In this review, we focused on the role of ECM proteins during attachment of the placenta to the uterine wall, its timely separation, and the implications of this process on retained or pathologically attached placenta. Although the amount of published information in this area is relatively scant, some

2017 Placenta

5. Placenta Praevia and Placenta Accreta: Diagnosis and Management

to be known by many different names, with ‘morbidly adherent placenta’ becoming particularly popular. This terminology was originally used in the 19 th century to describe the clinical complications associated with a retained placenta. This terminology is misleading as ‘morbidly adherent’ does not encompass the abnormally invasive end of the accreta spectrum (increta and percreta), which usually have the worst clinical outcomes. , In order to overcome these difficulties, the terms ‘placenta accreta (...) Placenta Praevia and Placenta Accreta: Diagnosis and Management Placenta Praevia and Placenta Accreta: Diagnosis and Management - Jauniaux - 2019 - BJOG: An International Journal of Obstetrics & Gynaecology - Wiley Online Library By continuing to browse this site, you agree to its use of cookies as described in our . Search within Search term Search term RCOG Green‐top Guideline Free Access Placenta Praevia and Placenta Accreta: Diagnosis and Management Green‐top Guideline No. 27a on behalf

2018 Royal College of Obstetricians and Gynaecologists

6. Tocolysis for management of retained placenta. (PubMed)

Tocolysis for management of retained placenta. Retained placenta affects 0.5% to 3% of women following delivery, with considerable morbidity if left untreated. Use of tocolytics, either alone or in combination with uterotonics, may be of value to minimise the need for manual removal of the placenta in theatre under anaesthesia.Evaluate the benefits and harms of tocolytics alone or in addition to uterotonics in the management of retained placenta in order to reduce the need for manual removal (...) of placenta.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2010) and contacted experts in the field.Any adequately randomised controlled trial (RCT) comparing the use of tocolytics, either alone or in combination with uterotonics, with no intervention or with other interventions in the management of retained placenta. All women having a vaginal delivery with a retained placenta, regardless of the management of the third stage of labour (expectant or active). We included

2011 Cochrane

7. The effects of sequential use of oxytocin and sublingual nitroglycerin in the cases of retained placenta. (PubMed)

The effects of sequential use of oxytocin and sublingual nitroglycerin in the cases of retained placenta. To evaluate the effects of adding sublingual nitroglycerin to oxytocin, for delivery of retained placenta after vaginal delivery.The study was performed as a placebo controlled clinical trial on women who did not finish delivering placenta after 30 min of active management of the third stage of labor. In case group, 1 mg nitroglycerin and in the control group, placebo was prescribed (...) sublingually.In total, 80 women finished the study. The number of manual removal of placenta did not show significant difference between the two groups [25 women (62.5%) in the case and 30 women (75%) in the control group, p = 0.335]. There was no significant difference between the two groups according to duration of the third stage of labor, hemoglobin index, decline in HB index >30% and maternal vital signs after treatment. There was no significant difference between the two groups according to adverse

2017 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

8. A pragmatic group sequential, placebo-controlled, randomised trial to determine the effectiveness of glyceryl trinitrate for retained placenta (GOT-IT): a study protocol. (PubMed)

A pragmatic group sequential, placebo-controlled, randomised trial to determine the effectiveness of glyceryl trinitrate for retained placenta (GOT-IT): a study protocol. A retained placenta is diagnosed when the placenta is not delivered following delivery of the baby. It is a major cause of postpartum haemorrhage and treated by the operative procedure of manual removal of placenta (MROP).The aim of this pragmatic, randomised, placebo-controlled, double-blind UK-wide trial, with an internal (...) pilot and nested qualitative research to adjust strategies to refine delivery of the main trial, is to determine whether sublingual glyceryl trinitrate (GTN) is (or is not) clinically and cost-effective for (medical) management of retained placenta. The primary clinical outcome is need for MROP, defined as the placenta remaining undelivered 15 min poststudy treatment and/or being required within 15 min of treatment due to safety concerns. The primary safety outcome is measured blood loss between

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2017 BMJ open

9. The inherited risk of retained placenta: a population based cohort study. (PubMed)

The inherited risk of retained placenta: a population based cohort study. To investigate whether retained placenta in the first generation is associated with an increased risk of retained placenta in the second generation.Population-based cohort study.Sweden.Using linked generational data from the Swedish Medical Birth Register 1973-2012, we identified 494 000 second-generation births with information on the birth of the mother (first-generation index birth). For 292 897 of these births (...) there was information also on the birth of the father.Risk of retained placenta in the second generation was calculated as adjusted odds ratios (aOR) by unconditional logistic regression with 95% confidence intervals (95% CI) according to whether retained placenta occurred in a first generation birth or not.Retained placenta in the second generation.The risk of retained placenta in a second-generation birth was increased if retained placenta had occurred at the mother's own birth (aOR 1.66, 95% CI 1.52-1.82

2017 BJOG

10. Placental location, postpartum hemorrhage and retained placenta in women with a previous cesarean section delivery: a prospective cohort study (PubMed)

Placental location, postpartum hemorrhage and retained placenta in women with a previous cesarean section delivery: a prospective cohort study Women previously giving birth with cesarean section have an increased risk of postpartum hemorrhage (PPH) and retained placenta. The objective of this study was to determine if anterior placental location increased the risk of PPH and retained placenta in such women.We performed a prospective cohort study on 400 women with cesarean section delivery (...) in a previous pregnancy. Ultrasound examinations were performed at gestational week 28-30, and placental location, myometrial thickness, and three-dimensional vascularization index (VI) were recorded. Data on maternal age, parity, BMI, smoking, gestational week at delivery, induction, delivery mode, oxytocin, preeclampsia, PPH, retained placenta, and birth weight were obtained for all women. Outcome measures were PPH (≥1,000 mL) and retained placenta.The overall incidence of PPH was 11.0% and of retained

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2017 Upsala journal of medical sciences

11. Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders

section and non-removal of the invasive placenta is an acceptable method of delivery but is associated with a protracted course of recovery and a persistent risk of hysterectomy (II-3B). 13 Women who retain their fertility following a diagnosis of placenta accreta spectrum disorder should be instructed to access specialist ultrasound early in any future pregnancy so that all management options are available should a Caesarean section scar pregnancy be found (III-B). 14 Prenatal diagnosis of the more (...) Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 41, Issue 7, Pages 1035–1049 No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders x Sebastian R. Hobson , MD MPH PhD Toronto, ON x John C. Kingdom , MD Toronto, ON x Ally Murji , MD

2019 Society of Obstetricians and Gynaecologists of Canada

12. High-intensity focused ultrasound combined with hysteroscopic resection to treat retained placenta accreta (PubMed)

High-intensity focused ultrasound combined with hysteroscopic resection to treat retained placenta accreta We present a case of retained placenta accreta treated by high-intensity focused ultrasound (HIFU) ablation followed by hysteroscopic resection. The patient was diagnosed as submucosal myoma based on ultrasonography in local clinic. Pathologic examination of several pieces of tumor mass from the hysteroscopic procedure revealed necrotic chorionic villi with calcification. HIFU (...) for a safe and effective method for treating retained placenta accreta to prevent complications from the remaining placental tissue and to improve fertility options.

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2016 Obstetrics & gynecology science

13. Two Different Regimens of Misoprostol in Retained Placenta

Two Different Regimens of Misoprostol in Retained Placenta Two Different Regimens of Misoprostol in Retained Placenta - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Two Different Regimens of Misoprostol (...) in Retained Placenta The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02704780 Recruitment Status : Completed First Posted : March 10, 2016 Last Update Posted : February 22, 2019 Sponsor: Hawler Medical University Information provided by (Responsible Party): Shahla Alalaf, Hawler Medical University Study

2016 Clinical Trials

14. The Correlation Between Clinical Diagnosis of Retained Placenta And Histology

The Correlation Between Clinical Diagnosis of Retained Placenta And Histology The Correlation Between Clinical Diagnosis of Retained Placenta And Histology - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more (...) . The Correlation Between Clinical Diagnosis of Retained Placenta And Histology (WHI) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02927730 Recruitment Status : Unknown Verified September 2016 by Bait Balev Hospital. Recruitment status was: Active, not recruiting First Posted : October 7, 2016 Last Update

2016 Clinical Trials

15. Oxidative stress and inflammation in retained placenta: a pilot study of protein and gene expression of GPX1 and NFκB. (PubMed)

Oxidative stress and inflammation in retained placenta: a pilot study of protein and gene expression of GPX1 and NFκB. Retained placenta is associated with severe postpartum hemorrhage. Its etiology is unknown and its biochemistry has not been studied. We aimed to assess whether levels of the antioxidative enzyme Glutathione Peroxidase 1 (GPX1) and the transcription factor Nuclear Factor κβ (NFκβ), as markers of oxidative stress and inflammation, were affected in retained placentas compared (...) to spontaneously released placentas from otherwise normal full term pregnancies.In a pilot study we assessed concentrations of GPX1 by ELISA and gene (mRNA) expression of GPX1, NFκβ and its inhibitor Iκβα, by quantitative real-time-PCR in periumbilical and peripheral samples from retained (n = 29) and non-retained (n = 31) placental tissue.Median periumbilical GPX1 concentrations were 13.32 ng/ml in retained placentas and 17.96 ng/ml in non-retained placentas (p = 0.22), peripheral concentrations were 13.27 ng

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2016 BMC Pregnancy and Childbirth

16. Different routes and forms of uterotonics for treatment of retained placenta: a randomized clinical trial. (PubMed)

Different routes and forms of uterotonics for treatment of retained placenta: a randomized clinical trial. To compare between three different uterotonics (oxytocin, carbetocin and misoprostol) given via three different routes (intraumbilical, intravenous and sublingual, respectively) in reducing the need for manual removal of placenta (MROP).A randomized trial for cases with retained placenta 30 min following vaginal delivery. They received intraumbilical oxytocin, intravenous carbetocin (...) or sublingual misoprostol. Main outcome measures were delivery of the placenta within 30 min following drug administration, and need for MROP. Secondary outcome measures were injection to placental delivery time, post-delivery hemoglobin, need for blood transfusion or additional uterotonics.The overall success rate was 66.7% (64/96), 71.3% (67/94) and 63.7% (58/91) for oxytocin, carbetocin and misoprostol groups, respectively (p > 0.05). When time needed to achieve placental delivery considered

2016 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

17. Macroscopic and histological characteristics of retained placenta: A prospectively collected case-control study. (PubMed)

Macroscopic and histological characteristics of retained placenta: A prospectively collected case-control study. Retained placenta is a potentially fatal obstetric disorder due to postpartum hemorrhage, its pathophysiology is however unknown. We aimed to assess if retained placenta was associated with increased macroscopic and histological signs of placental maternal underperfusion, a pattern otherwise seen in preeclampsia and other disorders of defective placentation.This was a case-control (...) study of retained (n = 49) and non-retained (n = 47) placentas, collected from full-term singleton and otherwise healthy pregnancies, carried out at a tertiary level obstetric department. Macroscopic and histological analysis was performed. Signs of maternal placental underperfusion and signs of placental inflammation, fetal vascular thrombo-occlusive disease and increased placental attachment were recorded in a primary and secondary analysis respectively. Variables were compared groupwise using

2016 Placenta

18. Retrospective Analysis of the Incidence of Retained Placenta in 3 Large Colonies of NHP (PubMed)

Retrospective Analysis of the Incidence of Retained Placenta in 3 Large Colonies of NHP During 1999 through 2014, retained placenta was the most common cause of clinical admission for reproductive complications in breeding colonies of baboons (approximate colony size, 2000 animals), cynomolgus macaques (approximately 1000), and rhesus macaques (approximately 500) at the Southwest National Primate Research Center. Retained placentas occurred in 2.7% of baboons, 3.3% of cynomolgus macaques (...) , and 1.0% of rhesus macaques. Apparent risk factors for retained placenta included stillbirth or abortion and at least one prior cesarean section. There was a significant association between stillbirth and retained placenta in all species. Cesarean sections were performed routinely for baboons to meet research objectives but occurred only as needed for cynomolgus and rhesus macaques. Having had at least one prior cesarean section was an incidence factor for retained placenta in 37.0% of baboons and 4.7

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2016 Comparative medicine

19. Retained Placenta

Retained Placenta Retained Placenta Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Retained Placenta Retained Placenta Aka: Retained (...) Never grasp placenta until it is separated Abdominal hand presses uterine fundus into placenta Prevents tearing of lower segment Consider placenta accreta (invasive placenta) if tissue plane is not easily distinguished on manual placenta removal Especially consider in , , advanced maternal age, high parity, prior placenta accreta High risk of life threatening (may require ) Placenta inspected for completeness Re-explore for any possible retained products Administer and massage VII. Prevention See

2018 FP Notebook

20. Retained Placenta: will medical treatment ever be possible? (PubMed)

Retained Placenta: will medical treatment ever be possible? The standard treatment for retained placenta is manual removal whatever its subtype (adherens, trapped or partial accreta). Although medical treatment should reduce the risk of anesthetic and surgical complications, they have not been found to be effective. This may be due to the contrasting uterotonic needs of the different underlying pathologies. In placenta adherens, oxytocics have been used to contract the retro-placental (...) treating the retained placenta as a single entity and to deliver targeted treatments. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

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2016 Acta Obstetricia et Gynecologica Scandinavica

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