Intraumbilical Misoprostol in Retained Placenta

Intra-umbilical Injection of Misoprostol Versus Normal Saline in the Management of Retained Placenta: Intrapartum Placebo-controlled Trial

Administration of intraumbilical misoprostol to women with retained placenta despite active management of third stage of labour reduces the need for manual removal of placenta and the amount of blood loss vaginally.

Retained placenta (RP)is one of the complications of third stage of labour; it should be managed promptly as it may cause severe bleeding, infection, maternal morbidity and mortality .The current standard management of RP word wide, by manual removal aims to prevent these problems, but it is unsatisfactory method because it requires general anaesthesia in hospital, It is an invasive procedure with its own serious complications of bleeding, infection and genital tract injury. Umbilical vein injection of misoprostol is a simple, safe method and could be performed at the place of delivery .

4 misoprostol tablets (Misotac® 200 micrograms tablet) dissolved in 20 ml of normal saline injected to umbilical vein

The administration of intraumbilical misoprostol to women with retained placenta despite active management of third stage of labour reduces the need for manual removal of placenta under general anaesthesia.

using intraumbilical misoprostol in women with retained placenta reduces the amount of blood loss vaginally.

Local applications of misoprostol through umbilical vein is associated with less side effects like shivering, fever, dizziness vomiting, flushes, nausea, abdominal pain and headache

Inclusion Criteria: women having singleton pregnancy 28 weeks of gestation or more delivered vaginally prolongation of the third stage of labour (more than 30 min) following active management of third stage of labour Exclusion Criteria: Who refused to participate in the trial Multiple pregnancies Previous Caesarean Section Haemodynamically unstable Severe anaemia (haemoglobin less than 8gm/dl) Chorioamnionitis