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Retained placenta: will medical treatment ever be possible?
- Source :
- Acta Obstetricia et Gynecologica Scandinavica, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- The standard treatment for retained placenta is manual removal whatever its subtype (adherens, trapped or partial accreta). Although medical treatment should reduce the risk of anesthetic and surgical complications, they have not been found to be effective. This may be due to the contrasting uterotonic needs of the different underlying pathologies. In placenta adherens, oxytocics have been used to contract the retro‐placental myometrium. However, if injected locally through the umbilical vein, they bypass the myometrium and perfuse directly into the venous system. Intravenous injection is an alternative but exacerbates a trapped placenta. Conversely, for trapped placentas, a relaxant could help by resolving cervical constriction, but would worsen the situation for placenta adherens. This confusion over medical treatment will continue unless we can find a way to diagnose the underlying pathology. This will allow us to stop treating the retained placenta as a single entity and to deliver targeted treatments.
- Subjects :
- Tocolytic agent
medicine.medical_specialty
way through medical treatment
Clinical Decision-Making
Uterotonic
Umbilical vein
Adherens junction
03 medical and health sciences
0302 clinical medicine
Retained placenta
Pregnancy
Oxytocics
Placenta
medicine
Humans
medical treatment
030212 general & internal medicine
reproductive and urinary physiology
030219 obstetrics & reproductive medicine
business.industry
Myometrium
Disease Management
Obstetrics and Gynecology
General Medicine
medicine.disease
Musculoskeletal Manipulations
Surgery
Tocolytic Agents
medicine.anatomical_structure
postpartum hemorrhage
embryonic structures
Commentary
Female
Risk Adjustment
delivery
business
Placenta, Retained
Subjects
Details
- ISSN :
- 00016349
- Volume :
- 95
- Database :
- OpenAIRE
- Journal :
- Acta Obstetricia et Gynecologica Scandinavica
- Accession number :
- edsair.doi.dedup.....2cbcb40b32d3aedaac2a7a8ad04c5fb7