retained placenta
A retained placenta occurs when the placenta is not delivered within 30 minutes of the baby's birth. This is a serious problem because it can lead to severe infection or life-threatening blood loss.
Retained placenta is not a common condition, but because of its seriousness, it must be managed by a medical team.
What causes placenta retention?
The placenta may be retained if contractions are not strong enough to expel it, or if the cervix closes and retains the placenta inside the uterus.
You're at greater risk of retained placenta if you're over 30, have a premature baby, or if your first and second stages of labor were very long. It can also occur if you have fibroids or another uterine problem.
Many women will receive an injection of Syntocinon (a synthetic version of the hormone oxytocin), which not only helps deliver the placenta but also helps reduce the risk of postpartum hemorrhage. This injection is called "active management." If the mother chooses not to have the injection, it is called "expectant management."
What are the symptoms of placenta retention?
The main symptom of a retained placenta is that the placenta doesn't fully exit the uterus after the baby is born. Bleeding before the placenta is delivered may be another symptom.
If a piece of the placenta is left behind, you may experience symptoms days or weeks after delivery. These may include:
- fever
- foul-smelling vaginal discharge
- severe bleeding
- Large pieces of tissue coming out of the vagina
- pain
What is the treatment for retained placenta?
Sometimes, a retained placenta can be treated simply by emptying your bladder, changing your position, and having the doctor or midwife gently pull on the umbilical cord.
If this doesn't work, you'll need a procedure to remove the placenta. You'll have surgery after delivery and receive an epidural or anesthetic so you won't feel anything. Your doctor will use an instrument called a curette to remove the lining of your uterus.
While you wait for surgery, the medical team will closely monitor you to ensure you don't bleed excessively (postpartum hemorrhage). The procedure itself is quick, but you'll need to be monitored for several hours afterward to ensure you don't bleed too much.
If you begin experiencing some of the symptoms above in the days and weeks following your baby's birth, it's important to see your doctor immediately. It's not always clear after the placenta is delivered; some tissue may have been left behind, which can lead to infection and bleeding. If you experience heavy bleeding after giving birth, you'll need surgery to determine the cause.