Umbilical vein oxytocin for the treatment of retained placenta (Release Study): a double-blind, randomised controlled trial

The retained placenta: Historical and geographical rate variations

“…During the course of a recent international study of RPs in the UK and Uganda it was noted that the rate of RP in the UK was significantly higher than in Uganda (Weeks et al 2010). There has been limited research into the difference in reported incidences of RP, and the cause of lower rates of RP in low-resource settings, such as Uganda, is unknown.…”

What is the optimal pharmacological management of retained placenta?

“…1 However, after this guideline was produced, a high quality RCT that compared intraumbilical oxytocin with placebo found no significant difference in rates of manual removal of the placenta (0.98, 0.87 to 1.12; 577 participants). 5 When the review was updated with these new data, no significant difference was seen in rates of manual removal (0.85, 0.72 to 1.00; 10 RCTs; 1227 participants) (table⇓). 6 There were also no significance differences in postpartum haemorrhage, defined as estimated blood loss over 0.5 L (1.03, 0.73 to 1.47; five RCTs; 860 participants); infection (1.33, 0.93 to 1.91; three RCTs; 577 participants); or surgical evacuation of retained products of placenta (0.89, 0.55 to 1.42; two RCTs; 814 participants).…”

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

“…In a recently concluded double blind randomized control trial, Weeks et al . detected no difference between the groups in the need for manual removal of placenta (oxytocin 179/292 [61.3%] compared to placebo 177/285 [62.1%]; relative risk 0.98, 95%CI 0.87–1.12; P = 0.84) 15 . In our study, using higher doses of oxytocin, we found statistically significant reduction in the need for formal manual removal of the placenta in women receiving intra‐umbilical oxytocin compared to women receiving the same volume of intra‐umbilical NS.…”

“…A Cochrane review concludes that the use of umbilical oxytocin is effective in the management of retained placenta, even though their meta-analysis showed the reduction in retained placenta rate not to be significantly different to that obtained in expectant management (odds ratio [OR] 0.86, 95%CI 0.71-1.01). 14 The basis for this conclusion was additional data from randomized comparison of umbilical oxytocin and umbilical saline, which showed a significant reduction in the need for manual removal of placenta with umbilical oxytocin injection (OR 0.79, 95%CI 0.69-0.92 15 In our study, using higher doses of oxytocin, we found statistically significant reduction in the need for formal manual removal of the placenta in women receiving intra-umbilical oxytocin compared to women receiving the same volume of intra-umbilical NS. The success rates were 51.72% and 20.69%, respectively, in the two study groups.…”