Rectal Misoprostol in Management of Retained Placenta: A Contradictory Result
Saipin Pongsatha MD*, Theera Tongsong MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Background : Retained placenta is one of the common problems in obstetric practice. The most common procedure to manage
cases with retained placenta is manual removal of placenta (MROP) under general anesthesia. Recent data indicates that
misoprostol may be helpful in decreasing the rate of MROP.
Objective : To assess the efficacy of rectal misoprostol in women with delayed placental separation.
Material and Method: A descriptive, retrospective cohort was conducted. All pregnant women with retained placenta longer
than 30 minutes after fetal delivery, either in second or third trimester that received 800 mcg rectal misoprostol were included
in the present study. Successful treatment was defined as spontaneous placental expulsion within 30 minutes after rectal
misoprostol administration.
Results : The rate of spontaneous placental expulsion within 30 minutes after misoprostol administration was very low, only
three out of 20 cases (15%).
Conclusion : High dose rectal misoprostol does not give a promising result in cases of retained placenta. It is ineffective to
facilitate placental separation in cases of retained placenta and does not seem to decrease the rate of MROP.
Keywords : Misoprostol, Retained placenta, Manual removal of placenta
