Cited by 182Maternal and fetal healthcareMaternal and Perinatal Health InterventionsPregnancy and preeclampsia studies

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The retained placenta.

Weeks, Andrew D.·2008·Best Practice & Research Clinical Obstetrics & Gynaecology

DOI 10.1016/j.bpobgyn.2008.07.005

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Abstract

The incidence and importance of retained placenta (RP) varies greatly around the world. In less developed countries, it affects about 0.1% of deliveries but has up to 10% case fatality rate. In more developed countries, it is more common (about 3% of vaginal deliveries) but very rarely associated with mortality. There are three main types of retained placenta following the vagina delivery: placenta adherens (when there is failed contraction of the myometrium behind the placenta), trapped placenta (a detached placenta trapped behind a closed cervix) and partial accreta (when there is a small area of accreta preventing detachment). All can be treated by manual removal of placenta, which should be carried out at 30-60 minutes postpartum. Medical management is also an option for placenta adherens and trapped placenta. The need for manual removal can be reduced by 20% by the use of intraumbilical oxytocin (30 i.u. in 30 mL saline). A trapped placenta may respond to glyceryl trinitrate (500 mcg sublingually) or gentle, persistent, controlled cord traction.

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Self-citation

See all 182

Authors: Weeks, A. D.
Affiliations: Liverpool Women's Hospital (GB)
Corresponding author: Weeks, Andrew D.
ORCID: Weeks, Andrew D.
Venue: Best Practice & Research Clinical Obstetrics & Gynaecology
Publisher: Elsevier BV
Published: 2008-12
Volume: 22
Issue: 6
Pages: 1103-1117
ISSN: 1521-6934 (ISSN-L)
DOI: 10.1016/j.bpobgyn.2008.07.005
OpenAlex: W2122682633
Cited by: 182
References: 57
Citations by year: 2026: 7 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 2 · 2021: 9 · 2020: 8 · 2019: 7 · 2018: 8 · 2017: 64 · 2016: 7 · 2015: 12 · 2014: 11 · 2013: 7 · 2012: 9
FWCI: 5.64
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Best Practice & Research Clinical Obstetrics & Gynaecology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords: retained placenta, manual removal of placenta, nitroglycerin, controlled cord traction, postpartum hemorrhage, vaginal delivery
MeSH terms: Female, Nitroglycerin, Humans, Labor Stage, Third, Oxytocics, Oxytocin, Pregnancy, Umbilical Cord, Placenta, Retained

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