Introduction and General Data
Retained placenta is a condition which features with the remnant parts of placenta after the birth of a baby. What normally happens is that after a baby is expelled through a birth canal the placenta is expelled as well in a period that lasts no longer that an hour. In case that placenta does not come out on its own, the gynecologist will assist in its elimination.
There are three types of retained placenta. The first one is trapped placenta. In this case the placenta has detached completely but it is held within the uterus due to the closure of the cervix. Placenta accreta has grown too deep into the uterus therefore cannot deattach properly and spontaneously. And finally in case of placenta adherens the contractions of the uterus are not strong enough or there are no contractions which will assist in the placental removal.
Complications of Retained Placenta
The very presence of retained placenta is life threatening condition. It is related to the bleeding after the child birth. Namely, after the placenta is eliminated uterus contracts and the bleeding stops. However, if there are parts of placenta left or in case that the whole placenta is retained the uterus cannot contract properly and the bleeding is prolonged. Huge loss of blood requires blood transfusions.
In case that placenta has completely detached from the uterine wall but it cannot leave the cavum uteri the doctor can remove it just by simple traction of the umbilical cord.
Manual removal is done in delivery room or in an operating room. The procedure is done by the very hands of the doctor. The doctor uses his/ her hands, puts them into the uterus and pulls the placenta out of the uterus. If the removal cannot be done by hands the doctor uses additional surgical instruments. Sometimes it is not possible to remove the whole of the placenta in one piece. In this case placenta is removed in parts.
The complications may occur as a consequence of manual removal of retained placenta. During the manual removal genital tract can be damaged and bacteria can be introduced so that a woman may eventually end up with severe puerperal infection. Sometimes the prophylactic usage of antibiotics may prevent the later infection.
The complication also occurs if placenta cannot be detached from the uterus and in these extreme cases a woman needs to undergo hysterectomy which is a complete surgical removal of the uterus. Without uterus a woman loses the ability to become pregnant again.