No reduction of manual removal after misoprostol for retained placenta: a double-blind, randomized trial.

OBJECTIVE

To test the effect of 800 μg of misoprostol orally on the prevention of manual removal of retained placenta.

DESIGN

Multicenter, double-blinded, placebo-controlled, randomized trial.

SETTING

One university and one non-university teaching hospital in the Netherlands.

SAMPLE: 99 women with retained placenta (longer than 60 min after childbirth) in the absence of postpartum hemorrhage.

METHODS

Eligible women were administered either 800 μg of misoprostol or placebo orally.

MAIN OUTCOME MEASURES: Number of manual removals of retained placenta and amount of blood loss.

RESULTS

Manual removal of retained placenta was performed in 50% of the women who received misoprostol and in 55% who received placebo (relative risk 0.91, 95% confidence interval 0.62-1.34). No difference in the amount of blood loss (970 vs. 1120 mL; p = 0.34) was observed between the two groups.

CONCLUSIONS

Administration of 800 μg of oral misoprostol, one hour after childbirth, does not seem to reduce the number of manual removals of retained placentas. The time elapsing results in the delivery of 50% of the retained placentas at the expense of an increased risk of postpartum hemorrhage.