Intraumbilical injection of uterotonics for retained placenta

Abstract

Objective: To assess the effect of injecting an uterotonic agent in the umbilical vein during the third stage of labor in women with retained placentas.

Methods: In this prospective clinical study, 75 women with retained placentas received 20 mL of a 0.9% saline solution with either 20 IU of oxytocin (n=54), 0.5 mg of carboprost tromethamine (n=7), or 0.2 mg of methylergometrine (n=14) injected in the umbilical vein after clamping. The treatment success was determined by the clinical signs of placental ablation.

Results: There were no statistically significant differences among the 3 therapeutic groups regarding age, parity, risk factors, pregnancy duration, type of delivery (spontaneous, induced, or augmented), or possible early postpartum complications caused by the intraumbilical injection. The rates of therapeutic success were 76.9% in the oxytocin group, 85.7% in the synthetic prostaglandin group, and 64.2% in the methylergometrine group.

Conclusion: The intraumbilical injection of uterotonics is a noninvasive, effective, and clinically safe method of shortening the third stage of labor in women with retained placentas.