Retained Placenta - Antibiotic prophylaxis

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ManagementTreatment

If woman is bleeding, manage as PPH

If the woman is not bleeding:

  • Set up IV normal saline infusion
  • Empty the bladder (voluntarily or catheterise)
  • Encourage breastfeeding
  • Repeat controlled cord contraction

If placenta is not delivered in another 30 minutes

  • Perform manual removal of placenta (use diazepam 10 mg IM/IV)
  • Repeat Oxytocin 10 IU IM or slow IV injection after manual removal
  • If no signs of infection and no obstructed labour: Give ceftriaxone 2 g IV stat
  • If signs of infection, give antibiotics as in amnionitis
  • If obstructed labour, give antibiotic prophylaxis as indicated in Obstructed labour

If unable to remove placenta manually

  • Give ceftriaxone 2 g IV stat
  • Give oxytocin 20 IU in Normal saline 500 cc at 30 drops per minute during transfer
  • Refer to HC4 or Hospital