Updates on Using Prostaglandins for the Management of Retained Placenta: A Systematic Review

Abstract

Objectives: To review the current evidence on the management strategies using prostaglandin analogues for the retained placenta (RP). Methods: A comprehensive exploration of relevant databases was conducted to identify studies meeting the inclusion criteria. To locate relevant literature, a comprehensive search of PubMed, Web of Science, SCOPUS, and Science Direct was carried out. The entire procedure made use of the Rayyan QRCI. Results: Fifteen trials including 2604 women with retained placenta were included in our data. Only two studies documented that there was no difference between the effectiveness of prostaglandin and other comparators; sulprostone and 400 µg misoprostol. Six studies stated that prostaglandins, mainly misoprostol, MPR more effective than the comparator groups in decreasing blood loss and requirement for manual placenta removal. Rectal administration of prostaglandin analogues was effective in decreasing postpartum hemorrhage. The prostaglandin administration sublingually, orally, and vaginally was not effective in decreasing MRP or blood loss. Conclusion: In comparison with, oxytocin, oxytocin agonists, ergometrine, and placebo the use of prostaglandins through intraumbilical vein injection and rectally was superior and showed better results in managing retained placenta. To select which prostaglandin to use and at what dose for the medical management of retained placenta, more research is required.