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Risks of retained placenta include hemorrhage and infection. After the placenta is delivered, the uterus should contract down to close off all the blood vessels inside the uterus. If the placenta only partially separates, the uterus cannot contract properly, so the blood vessels inside will continue to bleed.
Intravenous or intramuscular oxytocin is the drug of choice for postpartum hemorrhage. [19] [20] Ergotamine may also be used. [2] Oxytocin helps the uterus to contract quickly and the contractions to last longer. [21] It is the first line treatment for PPH when its cause is the uterus not contracting well. [22]
Antibiotics have been used to prevent and treat these infections—however, the misuse of antibiotics is a serious problem for global health. [2] It is recommended that guidelines be followed that outline when it is appropriate to give antibiotics and which antibiotics are most effective.
Types of Uterotonic drugs with pertinent drug information adapted from Obstetric Anesthesiology. [6] Utertonic Administration Onset Duration of Action Common Side Effects Contraindications Oxytocin: IV Bolus IV continuous infusion Intramuscularly (IM) IV: < 1 min IM: 3-5 min IV: 20 min IM: 30-90 min IV: Hypotension, tachycardia, arrhythmia
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Chorionic hematoma is the pooling of blood between the chorion, a membrane surrounding the embryo, and the uterine wall. [2] It occurs in about 3.1% of all pregnancies , [ 2 ] it is the most common sonographic abnormality and the most common cause of first trimester bleeding .
Couvelaire uterus is a phenomenon where the retroplacental blood may penetrate through the thickness of the wall of the uterus into the peritoneal cavity. This may occur after abruptio placentae. The hemorrhage that gets into the decidua basalis ultimately splits the decidua, and the haematoma may remain within the decidua or may extravasate ...
[1] [2] Such bleeding could be visible or external, namely bleeding from the vagina, or it could be internal into the pelvic cavity or form a hematoma. Normal menstruation is not considered a gynecologic hemorrhage, as it is not excessive. Hemorrhage associated with a pregnant state or during delivery is an obstetrical hemorrhage.