Efficacy of intra-umbilical oxytocin in the management of retained placenta: A randomized controlled trial
Article first published online: 13 AUG 2012
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology
Journal of Obstetrics and Gynaecology Research
Volume 39, Issue 1, pages 75–82, January 2013
How to Cite
Samanta, A., Roy, S. G., Mistri, P. K., Mitra, A., Pal, R., Naskar, A., Bhattacharya, S. K., Pal, P. P. and Pande, A. (2013), Efficacy of intra-umbilical oxytocin in the management of retained placenta: A randomized controlled trial. Journal of Obstetrics and Gynaecology Research, 39: 75–82. doi: 10.1111/j.1447-0756.2012.01974.x
- Issue published online: 7 JAN 2013
- Article first published online: 13 AUG 2012
- Received: November 24 2011.; Accepted: May 10 2012.
- intra-umbilical oxytocin;
- manual removal of placenta;
- randomized controlled trial;
- retained placenta
Aim: Retained placenta is an important cause of maternal mortality. The present study was aimed to determine the efficacy of umbilical injection of oxytocin as a treatment modality in this condition.
Material and Methods: This was a single-center randomized controlled trial incorporating 58 women with retained placenta of more than 30 min, equally distributed into two study arms of intra-umbilical injection of oxytocin (50 IU oxytocin diluted with normal saline [NS] to a total volume 30 mL) and intra-umbilical injection of NS (30 mL). Primary outcome was expulsion of the placenta within 30 min following intervention. All the data were analyzed on an intention-to-treat basis.
Results: The success rate in the intra-umbilical oxytocin group was 51.72% compared to 20.69% in the control arm. This difference in the primary outcome was statistically significant with a P-value < 0.05 (P = 0.014) favoring intra-umbilical oxytocin infusion with an efficacy rate of 1.5 and a number-needed-to-treat of 3. The peripartum bleeding complications were more in the NS group with a statistically higher (P < 0.001) requirement of extra oxytocin to control post-partum bleeding. There were no differences between the two groups in respect to other secondary outcomes, such as post-partum fever, antibiotic requirement and hospital stay.
Conclusion: Umbilical vein injection of 50 IU oxytocin in 30 mL of NS delivered effectively via the umbilical cord with milking in cases of retained placenta seems a simple and promising technique to reduce the incidence of a potentially morbid procedure and other complications.