Intra-umbilical vein oxytocin in the management of retained placenta: a random, prospective, double blind, placebo controlled study

Intraumbilical injection of uterotonics for retained placenta

“…Analyzying the results of recent multicenter, randomized, controlled study conducted from the Department of Gynecology and Obstetrics of Liverpool University Hospital, Weeks and coinvestigators [20] reported that a single 50-IU oxytocin dose injected in the umbilical artery provoked placental expulsion. However, a study by Frappel and coinvestigators [21] reported that a mere 0.5 IU of oxytocin suspended in 20 mL of saline solution achieved significant results. The mechanism of action is based on a dual effect, i.e., the separation of the placenta from its bed by the sheer volume injected as well as the strong uterine contractions.…”

“…Although Pipingas and coworkers [15] introduced the intraumbilical infusion of oxytocin, rather than the single injection, and obtained a higher rate of success (77.7% vs. [12] Oxytocin 40 (30) Golan [3] Oxytocin 100 (all) Bider [6] PgF2 α 100 (10) Oxytocin 54 (11) Huber [8] Oxytocin 220 (38) Weeks [20] Oxytocin 572 (76) Frappel [21] Oxytocin 14 (64) Gazvani [11] Oxytocin 28 (46.2) Wilken-Jensen [19] Oxytocin 40 (100) Carroli [18] Oxytocin 291 (58) Habek [17] Oxytocin 47 (80.8)…”

Efficacy of intra‐umbilical oxytocin in the management of retained placenta: A randomized controlled trial

“…Most studies to date have failed to demonstrate a significant reduction in the need for manual removal of the placenta, although the trend is towards a beneficial effect 5,7–13 . Gazvani et al 5 .…”

Management of retained placenta by umbilical vein injection

“…Six controlled trials have assessed the use of umbilical vein injections for the treatment of retained placenta (Selinger et al 1986; Hansen et al 1987; Kristiansen et al 1987; Frappell et al 1988; Wilken‐Jensen et al 1989; Thiery 1990). The upper time limit for defining ‘retained placenta’, ranged between 15 and 30 min after the birth of the baby.…”

“…Table 1 shows the results of the six trials in which umbilical vein oxytocin injection has been compared either with umbilical vein injection of saline solution (Selinger et al 1986; Frappell et al 1988; Hansen et al 1987; Kristiansen et al 1987; Wilken‐Jensen et al 1987) or with ‘expectant’ management (Kristiansen et al 1987; Thiery 1990). The available data suggest that the treatment of retained placenta with intra‐umbilical vein injection of oxytocin is associated with a reduction in the use of manual removal of the placenta (typical odds ratio 0.50, 95% confidence interval 0.30–0.83).…”