Retained placenta

Pelvic pain, retained placenta, severe genital bleeding, shock, fetal bradycardia, and fetal and maternal death have been reported. 

Nitrous oxide appears to have little effect on uterine musculature. However, the halogenated anesthetics are potent uterine muscle relaxants and produce this effect in a concentration-dependent fashion. This pharmacologic effect can be used to advantage when profound uterine relaxation is required for an intrauterine fetal manipulation or manual extraction of a retained placenta during delivery. However, it can also lead to increased uterine bleeding. 

All these substances have the function of promoting blood circulation and stopping bleeding. They are particularly used when the bleeding is caused by obstruction of congealed blood, such as in menorrhagia caused by hysteromyoma, and heavy bleeding due to retained placenta after labor. 

The work of Jackson and Halbert with cattle was briefly mentioned earlier (ref. 156a). Among the reproductive effects of PBBs were evidence for early embryonic resorption, delayed parturition, large calves, frequently stillborn, negligible milk production, and dystocia. Prewitt et al. reported similar findings in a field study of contaminated animals namely, food consumption and milk production were reduced by one-half, cattle with more than 20 ppm of PBBs in their milk fat produced still bom or short-lived calves, had dystocia, and retained placentas were common, as was metritis. Similar symptoms appeared in cows with only 1 ppm of PBBs in their milk fat (ref. 158a). 

The treatment of retained placenta often includes i.m. oxytocin at a low dose (20 lU) every 30 min on six occasions (S. Vivrette, unpublished data, 2001) or a higher dose (up to 120 lU) every 90 to 120 min. Alternatively, oxytocin can be used... 

Mares undergoing treatment for retained placenta should have been vaccinated against tetanus within the past year. Mares that have been vaccinated adequately against tetanus but not at the time of foaling should be given tetanus toxoid to ensure sufficient protection. The routine administration of tetanus antitoxin to mares at foaling has been associated with the development of fatal hepatic necrosis (Theiler s disease). 

Three Hemandia species, namely, H. moerenhoutiana, H. nymphaeifolia (a synonym of H. peltata according to Kubitzki [2]), and H. voyronii, have been used ethnobotanically by inhabitants of Tonga and Madagascar to treat malaria [11,12], postpartum hemorrhage [13], retained placenta [13], and morning sickness [14],... 

Halothane relaxes uterine smooth muscle, a useful property for manipulation of the fetus (version) in the prenatal period and for delivery of retained placenta. 

In vitro studies have indicated that devil s claw caused contractions of the uterus. The authors of the study noted that this activity was consistent with traditional use for induction or acceleration of labor, or for expulsion of retained placentas (Mahomed and Ojewole 2006). Another in vitro study indicated that some mouse embryos incubated in a solution containing devil s claw had misshapen tails but were otherwise normal (Yokoyama et al. 2005). 

A report of 37,497 women who delivered in the UK in 1988 showed that in addition to the well-known risk factors to major PPH, other potential risks were obesity, a large baby, and a retained placenta in women classified initially as low risk [27]. The most common cause of PPH is uterine atony. It occurs in 2%-5% of deliveries. However, the majority is managed by conservative measures. Other causes of PPH are retained products of conception. 

A 26-year-old woman in the second stage of labor received an infusion of oxytocin 10 U/l in 5% dextrose at a variable rate of 10-150 ml/ hour. In the 5 hours after delivery, which was complicated by a retained placenta requiring general anesthesia for removal, she received isotonic fluid 5500 ml, 5% dextrose 3500 ml with oxytocin 50 U/l, hydroxyethyl starch 1000 ml, and 4 units of blood. She then received 5% dextrose 7500 ml with oxytocin 100 U/l over 15 hours 24 hours later her serum sodium concentration was 113 mmol/l. She became unconscious and had a generalized convulsion. She subsequently made a full recovery. 

Chronic toxicosis. Abortirjn occurs in cattle during the first two-thirds of gestation. Aborted calves are small and the dam usually has a retained placenta. 

Late-term abortions in cattle accompanied by edema of the udder, retained placentas, and metritis... 

Pmus pcmderosa (ponderosa pine, loblolly pind ne es cause an abortion syndrome ( plne needle abortion syndrcxne in cattle exposed during the third trimester. The toxin is unknown, but it is water-soluble and often causes udder edema, retained placenta, and metritis as well. 

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