Prophylactic antibiotics for manual removal of retained placenta in vaginal birth

Intrapartum oral azithromycin for maternal infection prophylaxis and the risk of postpartum hemorrhage: A secondary analysis of the A‐ PLUS trial

“…However, little is known about the potential benefits of prophylactic antibiotics in reducing the risk of PPH or the need for blood transfusion. A recent meta‐analysis of studies evaluating prophylactic antibiotics for manual removal of retained placenta in vaginal births reported minimal to no effect on the risk of PPH 16 . This finding is consistent with the results of our analysis.…”

Intrapartum oral azithromycin for maternal infection prophylaxis and the risk of postpartum hemorrhage: A secondary analysis of the A‐ PLUS trial

“…However, little is known about the potential benefits of prophylactic antibiotics in reducing the risk of PPH or the need for blood transfusion. A recent meta‐analysis of studies evaluating prophylactic antibiotics for manual removal of retained placenta in vaginal births reported minimal to no effect on the risk of PPH 16 . This finding is consistent with the results of our analysis.…”

Clinical algorithms for management of third stage abnormalities

“…Five were identified that dealt with management of retained placenta. One was the Mousa 2014 PPH overview, 31 which indicates that there is minimal evidence on surgical procedures, and the Chongsomchai review, which recommends prophylactic antibiotics after manual removal of placenta (MROP) 42 . Three were on treatments found to be ineffective: intra‐umbilical vein oxytocin, 39,55 nitroglycerine 40 and prostaglandins 41 …”

“…Management of retained placenta requires removal of the placenta, which can be done by repeat controlled cord traction (CCT) or manual removal from the vagina, both of which can be performed in the labour ward by a midwife or general doctor 17–23 . When the placenta is still attached, a full manual removal of placenta (MROP) is required without delay, preferably in the operating theatre or in the labour ward with adequate analgesia, followed by a 5‐day course of broad‐spectrum antibiotic 42,56 …”

Algorithms for managing third stage abnormalities

“…44,45,46 Some individual Randomised Controlled trials (e.g. CHAMPION, WOMAN) 22,34 and some case series related to PPH management are also included. 31,32 Algorithms were found in the FIGO 17 , RCOG 18 and SA-NCCEMD 35 publications; all are consistent with the PPH algorithm being presented.…”

Intrapartum oral azithromycin for maternal infection prophylaxis and the risk of postpartum hemorrhage: A secondary analysis of the A‐ PLUS trial

“…However, little is known about the potential benefits of prophylactic antibiotics in reducing the risk of PPH or the need for blood transfusion. A recent meta‐analysis of studies evaluating prophylactic antibiotics for manual removal of retained placenta in vaginal births reported minimal to no effect on the risk of PPH 16 . This finding is consistent with the results of our analysis.…”

Clinical algorithms for management of third stage abnormalities

“…Five were identified that dealt with management of retained placenta. One was the Mousa 2014 PPH overview, 31 which indicates that there is minimal evidence on surgical procedures, and the Chongsomchai review, which recommends prophylactic antibiotics after manual removal of placenta (MROP) 42 . Three were on treatments found to be ineffective: intra‐umbilical vein oxytocin, 39,55 nitroglycerine 40 and prostaglandins 41 …”

“…Management of retained placenta requires removal of the placenta, which can be done by repeat controlled cord traction (CCT) or manual removal from the vagina, both of which can be performed in the labour ward by a midwife or general doctor 17–23 . When the placenta is still attached, a full manual removal of placenta (MROP) is required without delay, preferably in the operating theatre or in the labour ward with adequate analgesia, followed by a 5‐day course of broad‐spectrum antibiotic 42,56 …”

Algorithms for managing third stage abnormalities

“…44,45,46 Some individual Randomised Controlled trials (e.g. CHAMPION, WOMAN) 22,34 and some case series related to PPH management are also included. 31,32 Algorithms were found in the FIGO 17 , RCOG 18 and SA-NCCEMD 35 publications; all are consistent with the PPH algorithm being presented.…”

Intrapartum oral azithromycin for maternal infection prophylaxis and the risk of postpartum hemorrhage: A secondary analysis of the A‐ PLUS trial

“…However, little is known about the potential benefits of prophylactic antibiotics in reducing the risk of PPH or the need for blood transfusion. A recent meta‐analysis of studies evaluating prophylactic antibiotics for manual removal of retained placenta in vaginal births reported minimal to no effect on the risk of PPH 16 . This finding is consistent with the results of our analysis.…”

Clinical algorithms for management of third stage abnormalities

“…Five were identified that dealt with management of retained placenta. One was the Mousa 2014 PPH overview, 31 which indicates that there is minimal evidence on surgical procedures, and the Chongsomchai review, which recommends prophylactic antibiotics after manual removal of placenta (MROP) 42 . Three were on treatments found to be ineffective: intra‐umbilical vein oxytocin, 39,55 nitroglycerine 40 and prostaglandins 41 …”

“…Management of retained placenta requires removal of the placenta, which can be done by repeat controlled cord traction (CCT) or manual removal from the vagina, both of which can be performed in the labour ward by a midwife or general doctor 17–23 . When the placenta is still attached, a full manual removal of placenta (MROP) is required without delay, preferably in the operating theatre or in the labour ward with adequate analgesia, followed by a 5‐day course of broad‐spectrum antibiotic 42,56 …”

Algorithms for managing third stage abnormalities

“…44,45,46 Some individual Randomised Controlled trials (e.g. CHAMPION, WOMAN) 22,34 and some case series related to PPH management are also included. 31,32 Algorithms were found in the FIGO 17 , RCOG 18 and SA-NCCEMD 35 publications; all are consistent with the PPH algorithm being presented.…”