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PubMed2001

Antioxidative defence mechanisms against reactive oxygen species in bovine retained and not-retained placenta: activity of glutathione peroxidase, glutathione transferase, catalase and superoxide dismutase.

Glutathione peroxidase (GSH-Px), glutathione transferase (GSH-Tr), catalase (CAT) and superoxide dismutase (SOD)-the members of enzymatic antioxidative defence mechanisms against reactive oxygen species-may play an important role in proper or improper release of bovine fetal membranes. The aim of the following study was the determination of GSH-Px, GSH-Tr, CAT and SOD activity in order to define antioxidative status of bovine placenta during retention of fetal membranes (RFM) in cows. Placental samples were collected immediately after spontaneous parturition or during caesarean section before term and at term and divided into six groups as follows: A: caesarean section before term without RFM; B: caesarean section before term with RFM; C: caesarean section at term without RFM; D: caesarean section at term with RFM; E: spontaneous delivery at term without RFM; F: spontaneous delivery at term with RFM. The enzyme activities in placental homogenates were measured spectrophotometrically. GSH-Px activity was statistically significantly higher in fetal than in maternal placenta in all examined groups, increased towards parturition and was higher in caesarean section groups than spontaneous delivery groups. Statistically significantly higher activities were noticed in retained than not-retained placentae. GSH-Tr activity was significantly lower in fetal than in maternal placenta. In preterm groups, the activity was statistically significantly higher in retained than not retained placenta. In term groups, the opposite relationship was observed, higher values in caesarean section groups than spontaneous delivery were noticed. CAT activity was statistically significantly higher in fetal than in maternal part of placenta in all groups examined. The highest values in C and D groups and the differences between retained and not-retained placenta were observed. SOD exhibited the highest values in preterm placenta and alterations between retained and not-retained fetal membranes. In conclusion, the activities of GSH-Px, GSH-Tr, CAT and SOD are altered in cases of retained fetal membranes which may suggest the activation of antioxidative mechanisms caused by the imbalance between production and neutralization of reactive oxygen species.

Animals↗
PubMed1996

Effects of fenprostalene and estradiol-17 beta benzoate on parturition and retained placenta in dairy cows and heifers.

It was hypothesized that a high dose of estrogen in conjunction with a long-acting PGF2 alpha analog would synchronize parturition within a narrow time frame and reduce the incidence of retained placenta. On d 276 of gestation, 14 animals (9 cows and 5 heifers) per group received a placebo (group A), 1 mg of fenprostalene (group B), 50 mg of estradiol-17 beta benzoate (group C), or both (group D). Treatment with estradiol-17 beta benzoate increased serum concentrations of estradiol-17 beta from 228 pg/ml at treatment to 642 and 683 pg/ml at 24 h posttreatment for groups C and D, respectively. Concentration of estradiol-17 beta in group A increased gradually to 526 pg/ml at 24 h prepartum. Progesterone concentrations were reduced by fenprostalene but not by estradiol-17 beta benzoate. Estradiol-17 beta benzoate did not reduce incidence of retained placenta in animals treated with fenprostalene (group B vs. group D) but tended to reduce incidence in uninduced animals (group A vs. group C). Thus, short-term elevation of estradiol-17 beta to normal prepartum concentrations did not regress the corpus luteum, induce parturition, or reduce incidence of retained placenta. However, elevation of estradiol-17 beta for longer periods might enhance placental separation. Conversely, fenprostalene induced calving approximately 2 d after treatment. In this study, 90% of animals treated with fenprostalene calved within a 20-h period, but with a high incidence of retained placenta.

Animals↗
PubMed1996

Intraumbilical vein injection of prostaglandin F2 alpha in retained placenta.

A randomized protocol was used to study the effect of intraumbilical prostaglandin F2 alpha (Hembate, Upjohn) and oxytocin injection in women with retained placenta. Prostaglandin F2 alpha, 20 mg, diluted to 20 ml in normal saline solution (10 women, group 1), 30 IU of oxytocin, diluted to 20 ml in normal saline solution (11 women, group 2), or 20 ml of normal saline solution alone (7 women, group 3), were injected into the umbilical vein 1 h after delivery. Nine women (group 4, controls) underwent manual removal of the retained placenta. In group 1, placental expulsion occurred in all patients and the duration of the placental expulsion after prostaglandin F2 alpha injection was 6.8 +/- 1.36 (mean +/- SE) min: in group 2, six placental expulsions occurred after 13.3 +/- 1.97 min (mean +/- SE); and in group 3, no effect was recorded after intraumbilical saline injection. We suggest that intraumbilical vein injection of prostaglandin F2 alpha might be a beneficial, non-surgical method for treating retained placenta. Oxytocin might reduce the incidence of manual lysis of the placenta and achieve partial success.

Adult↗
PubMed2002

8-iso-prostaglandin F2alpha as a marker of tissue oxidative damage in bovine retained placenta.

Retention of foetal membranes (RFM) in cows is supposed to be associated with the imbalance between production and neutralisation of reactive oxygen species (ROS). The consequence of uncontrolled ROS increase is oxidative damage to tissues, cells, and macromolecules. 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) is considered as a marker of oxidative tissue damage. The aim of the study was to investigate whether the concentrations of 8-iso-PGF2alpha, in caruncles and cotyledons from the bovine placenta differ between retained and properly released foetal membranes. Placentomes were collected immediately after either spontaneous delivery at term via the vagina or caesarean section before as well as at term through the incision and divided into six groups consisting of eight cows each as follows: A-preterm caesarean section without RFM, B-preterm caesarean section with RFM, C-term caesarean section without RFM, D-term caesarean section with RFM, E-term spontaneous delivery without RFM, F-term spontaneous delivery with RFM. The concentrations of free and total 8-iso-PGF2alpha, were determined in caruncles as well as cotyledons by enzyme immunoassay and expressed in picogram per gram of wet weight of tissue. The concentrations of free and total 8-iso-PGF2alpha were lower (P < 0.05) in cotyledons than in caruncles in all groups examined, as well as they were higher (P < 0.05) in retained than in released placenta. The concentrations of both parameters were lower (P < 0.05) in term spontaneous delivery groups than in term caesarean section groups. The results indicate that oxidative tissue damage, which may be the result of ROS imbalance, appears during RFM. However, the dynamics of this damage requires further elucidation.

Animals↗
PubMed1987

Peripartal endocrine changes associated with retained placenta in dairy cows.

Peripheral serum concentrations of prostaglandin F(2)alpha metabolite (PGFM), cortisol, and progesterone (P(4)) were determined in cows that retained placentae (RP; n = 18) and cows that did not retain placentae after parturition (NRP; n = 28). Blood samples collected from Day 15 before until Day 15 after parturition were assayed. Significant increases (P < 0.05) in PGFM concentrations occurred in RP cows between Days 7 and 6 before parturition compared with NRP cows. There were no differences in the interval required to attain peak concentrations of PGFM and the interval required to reach basal concentrations after parturition in both groups. However, the amount of PGFM secreted during the peripartum period was significantly higher in RP cows (P < 0.01). Starting from Day 6 before parturition, serum cortisol concentrations in RP cows increased significantly to peak levels 3 d before parturition (P < 0.05). Cortisol levels decreased to basal concentrations in RP cows on Day 1 postpartum. The peripartal serum P(4) concentrations in RP and NRP cows did not differ. The results indicate that prepartal PGFM and cortisol increases may constitute reliable indicators of retained placenta in dairy cows.

Journal Article↗
PubMed2000

Hysterotomy for retained placenta in a term angular pregnancy. A case report.

BACKGROUND: Angular placentation may be a cause of retained placenta and may require hysterotomy. CASE: A 33-year-old woman with a prior cesarean section underwent an uncomplicated vaginal delivery, had a retained placenta with postpartum hemorrhage and required hysterotomy because the placenta was inaccessible due to its angular location. CONCLUSION: Antepartum ultrasound diagnosis may be possible in some cases of angular placentation.

Adult↗
PubMed1997

Effect of retained placenta on subsequent bacteriological and cytological intrauterine environment and reproduction in Holstein dairy cows.

To determine the effect of retained placenta on the characteristics of the intrauterine environment in dairy cows, bacteriological and cytological tests were performed on intrauterine perfusion fluid. The rate of cows with more than 70% neutrophils or fewer than 40% lymphocytes in inflammatory cells was 48.0% (12/25), while the rate and with more than 50 bacterial colonies/0.1 ml of perfusate was 96.0% (24/25) at 30 d after parturition. Actinomyces pyogenes was isolated from 56.0% (14/25). At 60 d after parturition, however, these values were significantly improved to 20.0% (5/25), 48.0% (12/25) and 12.0% (3/25), respectively. No significant differences in subsequent reproductive performance were observed between cows with and without retained placenta. The results suggest that injury to the intrauterine environment caused by retained placenta is largely healed by 60 d after parturition.

Journal Article↗
PubMed2005

Sublingual nitroglycerin for management of retained placenta.

OBJECTIVE: The aim of the study was to investigate the effect of sublingual nitroglycerin for management of retained placenta and to assess possible adverse effects of the treatment. METHOD: Twenty-four women were randomly selected to receive either 1 mg nitroglycerin or placebo tablets sublingually if intravenous oxytocin and controlled umbilical cord traction had failed to expel the placenta. Success rate for delivery of placenta, blood pressure, pulse rate, blood loss, and various side effects were examined. RESULT: All 12 women in the nitroglycerin group had successful delivery of placenta, while removal of placenta was successful in only one of the 12 women in the placebo group. No adverse effects of clinical importance were registered. CONCLUSION: Sublingual nitroglycerin for treatment of retained placenta seems to be effective without causing serious adverse effects. However, the definite clinical value needs to be evaluated in larger series of patients.

Administration, Sublingual↗
PubMed2005

The Release Trial: a randomised controlled trial of umbilical vein oxytocin versus placebo for the treatment of retained placenta.

HYPOTHESIS: Intraumbilical injection of oxytocin reduces the incidence of manual removal compared with placebo in the treatment of retained placenta. ENTRY CRITERIA: The women recruited will be stable haemodynamically, not bleeding vaginally, over 34 weeks of gestation and with a retained placenta for at least 30 minutes. TREATMENT ARMS: Oxytocin (50 IU) or sterile water (in identical vials) in 25 mL saline injected through an intraumbilical venous catheter. SAMPLE SIZE: Five hundred seventy-two women. PRIMARY ENDPOINT: Need for manual removal of placenta. CENTRES: Initially, there will be two study sites in the UK (Liverpool and Sheffield) and five in Uganda (Mulago, Nsambia, Mengo, Rubaga and Arua). FUNDING: World Health Organization and WellBeing of Women.

Adult↗
PubMed1997

Extensive thrombophlebitis with reactive thrombocytosis in a high risk Chinese parturient associated with retained placenta increta: a case report.

Postpartum thrombophlebitis is an infrequent disorder in Chinese women. A case is reported of extensive postpartum thrombophlebitis involving 23 cm of the femoral and pelvic veins. This 25-year-old splenectomized victim of beta-thalassemia was bedridden for 12 weeks because of threatened premature labor before Cesarean delivery. During the operation, placenta increta with massive bleeding was encountered. To save the uterus, ten percent of the placenta was retained. Duplex color Doppler imaging was performed for the diagnosis and follow-up of the thrombosis and vigorous anticoagulation therapy successfully cured this patient.

Adult↗
PubMed2001

The levels of lipid peroxidation products in bovine retained and not retained placenta.

Unsaturated fatty acids undergo peroxidation processes. The presence of elevated levels of metabolites of lipid peroxidation processes may cause alterations in metabolic pathways which may lead to disturbances and clinical symptoms of illnesses. One such illness may be retention of fetal membranes (RFM) in cows. The aim of the study was the determination of thiobarbituric acid (TBA) reactive substances, conjugated dienes and hydroperoxides in bovine retained and not retained placenta in order to describe the oxidative status of cows affected with RFM. Placental samples were collected immediately after spontaneous delivery or caesarian section before term and at term and divided into 6 groups, with 16 animals in each group, as follows: A) caesarian section before term without RFM: B) caesarian section before term with RFM: C) caesarian section at term without RFM: D) caesarian section at term with RFM: E) spontaneous delivery at term without RFM; F) spontaneous delivery with RFM. The levels of TBA reactive substances, conjugated dienes and hydroperoxides were measured spectrophotometrically. The levels of all parameters were statistically significantly higher in the maternal than in the fetal part of placenta and the lowest in preterm groups. Statistically significantly higher concentrations in retained placenta samples than in control animals were observed. In conclusion, the metabolites of lipid peroxidation processes are elevated in cases of retained placenta and their presence might influence directly and/or indirectly the improper release of fetal membranes in cows.

Alkadienes↗
PubMed1998

Intraumbilical oxytocin for the management of retained placenta: a randomized controlled trial.

OBJECTIVE: To evaluate the ability of intraumbilical oxytocin injection as a treatment for retained placenta after vaginal delivery to reduce the incidence of manual removal and postpartum hemorrhage. METHODS: A randomized controlled trial was set up in a university and a district general hospital. We recruited 81 women with singleton pregnancies who underwent vaginal delivery and who failed to deliver the placenta after 20 minutes of active management of the third stage of labor. Study subjects were randomized to receive either 1) an intraumbilical injection of oxytocin (20 IU in 20 mL of saline); 2) an intraumbilical injection of saline (20 mL); or 3) no treatment. Outcome measures were expulsion of the placenta within 45 minutes of delivery, need for manual removal of the placenta under anesthesia, and postpartum hemorrhage (defined as a blood loss greater than 500 mL). RESULTS: Women given an intraumbilical injection of oxytocin had a significant increase in spontaneous expulsion of the placenta within 45 minutes of delivery and fewer manual removals of the placenta, compared with women without treatment (odds ratio [OR] 11.6, 99% confidence interval [CI] 1.4, 272.8; and OR 7.4, 99% CI 1.1, 86.5; respectively). When women given intraumbilical oxytocin were compared with women given only intraumbilical saline, the difference was not statistically significant (OR 6.6, 99% CI 0.9, 77.2 for spontaneous expulsion of the placenta; and OR 4.7, 99% CI 0.8, 39.5 for manual removal). There was no significant difference in the incidence of spontaneous expulsion and manual removal of the placenta between women given intraumbilical saline injection and women without treatment (OR 1.8, 99% CI 0.1, 53.9; and OR 1.6, 99% CI 0.1, 22.4; respectively). CONCLUSION: The results of our study suggest a clinically important beneficial effect of intraumbilical oxytocin injection in the management of retained placenta.

Adult↗