Nifedipine sublingual 20 mg or if available IV helps a lot in handling retained placenta. It relaxes the uterus and helps in manual separation of difficult retained placentas. Along with a good depth of anesthesia with opioids, hyoscine, inhalation anesthesia, Ketamine or a combination of 20 mg Nifedipine sublingual 10 mins before or IV infusion helps in getting the placenta out easily. Nowadays, Nifedipine is being used in cream/ jelly form along with Lidocaine, to relieve pain in anal fissure. It helps in relaxing anal sphincter. Smooth muscle relaxant action.
The same action can be used for relaxing uterine muscle also. I did a series of 10 cases with a clear-cut difference. Easy expulsion of a previously difficult retained placenta. Please try this for very difficult retained placentas. Share your views.
