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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. Full Text available with Trip Pro

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

2015 Cochrane

3. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. Full Text available with Trip Pro

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

2014 Cochrane

4. 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

5. Intra-umbilical vein injection of carbetocin versus oxytocin in the management of retained placenta. (Abstract)

Intra-umbilical vein injection of carbetocin versus oxytocin in the management of retained placenta. Retained placenta can be defined as lack of expulsion of the placenta within 30 min of delivery of the infant. It is a significant cause of maternal mortality and morbidity throughout the developing world.The aim of this study was to compare the efficacy of intra-umbilical vein injection of carbetocin versus oxytocin in the management of retained placenta.A total of 200 women were included (...) placenta. Intra-umbilical carbetocin seems to have more acceptable hemodynamic safety profile when compared to intra-umbilical oxytocin in the management of retained placenta.Copyright © 2019 Elsevier B.V. All rights reserved.

2019 Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives Controlled trial quality: uncertain

6. Management of postpartum pulmonary embolism combined with retained placenta accreta: A case report. Full Text available with Trip Pro

Management of postpartum pulmonary embolism combined with retained placenta accreta: A case report. Retained placenta accreta is an increasing obstetric problem in recent years, and pulmonary embolism (PE) during pregnancy and the postpartum period is a vital condition, but lack of standard therapy guidelines. This report describes a case of postpartum PE combined with retained placenta accreta.A 27-year-old woman presenting with fever and dyspnea after delivery was admitted to our hospital (...) with retained placenta accreta.The patient was diagnosed with the infection, postpartum PE, and residual placenta.The antibiotics and low molecular weight heparin were initially started to cure the infection and control PE. Mifepristone was then used to promote the necrosis of residual placenta while long-term use of warfarin was served as continuous anticoagulant therapy. Hysteroscopic resection of retained placenta was not performed until thrombi had been almost disappeared after more than 2 months

2019 Medicine

7. Anaesthesia/analgesia for manual removal of retained placenta [Cochrane protocol]

Anaesthesia/analgesia for manual removal of retained placenta [Cochrane protocol] Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing

2018 PROSPERO

8. Risk factors for retained placenta after vaginal delivery: a systematic review

Risk factors for retained placenta after vaginal delivery: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect

2018 PROSPERO

9. Extracellular matrix proteins in healthy and retained placentas, comparing hemochorial and synepitheliochorial placentas. (Abstract)

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

10. A pragmatic group sequential, placebo-controlled, randomised trial to determine the effectiveness of glyceryl trinitrate for retained placenta (GOT-IT): a study protocol. Full Text available with Trip Pro

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

2017 BMJ open Controlled trial quality: predicted high

11. The inherited risk of retained placenta: a population based cohort study. (Abstract)

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

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

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 Controlled trial quality: uncertain

13. Placental location, postpartum hemorrhage and retained placenta in women with a previous cesarean section delivery: a prospective cohort study Full Text available with Trip Pro

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

2017 Upsala journal of medical sciences

14. 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

15. Tocolysis for management of retained placenta. (Abstract)

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

16. 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

17. Placenta Accreta Spectrum

Placenta Accreta Spectrum Placenta Accreta Spectrum - ACOG Menu ▼ Placenta Accreta Spectrum Page Navigation ▼ Number 7 (Replaces Committee Opinion No. 529, July 2012) The Society of Gynecologic Oncology endorses this document. This document was developed jointly by the American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine with the assistance of Alison G. Cahill, MD, MSCI; Richard Beigi, MD, MSc; R. Phillips Heine, MD; Robert M. Silver, MD; and Joseph R (...) and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product. Placenta Accreta Spectrum ABSTRACT: Placenta accreta spectrum, formerly known as morbidly adherent placenta, refers to the range of pathologic adherence of the placenta, including placenta increta, placenta percreta, and placenta accreta. The most favored hypothesis regarding the etiology of placenta accreta spectrum is that a defect of the endometrial–myometrial interface

2019 American College of Obstetricians and Gynecologists

18. Tissue pathway for histopathological examination of the placenta

. In a small number of clinical situations, it may be appropriate for the examination to be limited to a macroscopic description, without sampling for histology (Appendix C). In this case, the placenta should be retained for at least two weeks in case the baby or mother becomes ill and placental histology becomes necessary. Some centres may prefer in these cases to provide a macroscopic description and take tissue blocks for processing only. Block-only cases may then be formally reported as per clinical (...) , indicating that histology will only be undertaken if clinically indicated. The placenta should be retained for a short period (1 2 weeks) in case serious neonatal complications occur or further clinical information comes to light necessitating histological sampling. 4.3 Report content See Section 3.8 for general comments. The histological report should be tailored to the specific clinical situation. Key elements to note include: the presence, severity and extent of acute inflammation in the cord, CEff

2017 Royal College of Pathologists

19. Prostaglandin analogues for management of retained placenta

Prostaglandin analogues for management of retained placenta Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures Timing

2016 PROSPERO

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

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 Controlled trial quality: uncertain

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