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A retained placenta is commonly a cause of postpartum haemorrhage, both primary and secondary. [1] Retained placenta is generally defined as a placenta that has not undergone placental expulsion within 30 minutes of the baby’s birth where the third stage of labor has been managed actively. [2]
667 Retained placenta or membranes, without hemorrhage; 668 Complication (medicine) of the administration of anesthetic or other sedation in labor (childbirth) and delivery; 669 Complication (medicine) Other complications of labor and delivery, not elsewhere classified. 669.5 Forceps delivery or vacuum extractor delivery without mention of ...
A retained placenta is a placenta that does not undergo expulsion within a normal time limit. Risks of retained placenta include hemorrhage and infection. If the placenta fails to deliver in 30 minutes in a hospital environment, manual extraction may be required if heavy ongoing bleeding occurs.
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening or opening) of the cervix and surgical removal of sections and/or layers of the lining of the uterus and or contents of the uterus such as an unwanted fetus (early abortion before 13 weeks), remains of a non-viable fetus, retained placenta after birth or abortion as well as any abnormal tissue which may be in the ...
Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the "four Ts": [12] Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding. Retained placental tissue and infection may contribute to uterine atony.
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]
Retained placental tissue or placental disorders, such as an adherent placenta, placenta previa, and abruption placentae increase the mother's risk of PPH. Body mass index (BMI) above 40 and coagulopathies are known risk factors. [1] [3] [2] [4]
Retained placenta fragments is an outcome of failure in the complete expulsion of the placenta, and contributes to DOL. [13] [17] Residual portions of the placenta continue to secrete progesterone, which inhibits progesterone withdrawal and subsequently hinders the initiation of lactogenesis II.