Umbilical vein injection of 400 versus 800 μg misoprostol for the treatment of retained placenta: A multicenter, randomized double-blind controlled trial

Alalaf SK 1 , Al Tawil NG 2 , Jawad AK 3 , Mahmoud MB 4 , Muhamad BQ 5 , Abdul Rahman KH 5 Show all authors , Sileem SA 6 , Hassan JN 7 , Ameen KM 8 , Mustafa SA 1 , Bawadikji AA 9

Affiliations 

  • 1 Department of Obstetrics and Gynecology, Hawler Medical University, College of Medicine, Erbil City, Iraq
  • 2 Department of Community Medicine, Hawler Medical University, College of Medicine, Erbil City, Iraq
  • 3 Department of Obstetrics and Gynecology, Kurdistan Board for Medical Specialties, Erbil City, Iraq
  • 4 Department of Obstetrics and Gynecology, University of Sulaimani, College of Medicine, Sulaimani City, Iraq
  • 5 Hawler Ministry of Health, Directorate of Health, Maternity Teaching Hospital, Erbil City, Iraq
  • 6 Department of Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Assuit City, Egypt
  • 7 Department of obstetrics and Gynecology, University of Duhok, College of Medicine, Duhok City, Iraq
  • 8 Department of Obstetrics and Gynecology, University of Kirkuk, Kirkuk Medical College, Kirkuk City, Iraq
  • 9 School of Pharmaceutical Science, University Sains Malaysia, Penang, Malaysia
J Obstet Gynaecol Res, 2020 May;46(5):727-735.
PMID: 32157797 DOI: 10.1111/jog.14232

Abstract

AIMS: This trial was conducted to determine the efficacy of umbilical vein injection of 400 versus 800 μg misoprostol to deliver retained placenta and to compare both regimens regarding the time of placental delivery and amount of vaginal blood loss.

METHODS: A double-blind, multicenter randomized clinical trial was undertaken in four teaching hospitals in the North of Iraq and Al-Azhar University Hospital in Egypt, from March 2016 to May 2019. Group I (274 women) received 400 μg misoprostol and group II (249 women) received 800 μg misoprostol. Data regarding the time of placental separation and amount of vaginal blood loss were analyzed and proportions were compared between groups using Chi-squared test. Mean values were compared using the Student's t-test. The Mann-Whitney test was used to determine the median of vaginal blood loss.

RESULTS: The proportion of placental separation was 84.3% among women in group I and 86.7% of women in group II. The mean time of placental separation was 18.86 ± 234.2 and 17.86 ± 213.09 min in groups I and II, respectively (P

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