Bibliographic information
GuidelineConsolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
Umbilical vein injection of oxytocin is recommended for the treatment of retained placenta only in the context of rigorous research
Recommendation in research context
Only in research contexts
Notes and Remarks
- The GDG acknowledged the potential of umbilical vein injection of oxytocin solution in the treatment of the retained placenta but considered the evidence of benefit in terms of manual removal of the placenta without impact on other priority outcomes insufficient to make a recommendation for routine clinical practice. The group agreed that high-quality randomized trials comparing umbilical vein injection of uterotonics with expectant management of women with a retained placenta are needed, with the aim of demonstrating its impact on severe postpartum haemorrhage-related morbidity in addition to a reduction in manual removal of the placenta.
- When used in a research context, it is safer to consider the use of this intervention in situations in which a retained placenta occurs in the absence of abnormal bleeding.
- There are three types of retained placenta; umbilical vein injection of oxytocin is likely to be only effective in treating placenta adherens, the most common type of retained placenta, which occurs because of failed contraction of the retroplacental myometrium. To date, studies have not distinguished the subtypes before treatment; this may have contributed to the results showing lack of efficacy of treatment with umbilical vein injection for the retained placenta