Retained Placenta Management

A retained placenta is commonly a cause of postpartum haemorrhage, both primary and secondary. 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 labour has been managed actively.

Drugs, such as intravenous oxytocin, are often used in the management of placental retention. It is useful ensuring the bladder is empty. However, ergometrine should not be given as it causes tonic uterine contractions which may delay placental expulsion. Controlled cord traction has been recommended as a second alternative after more than 30 minutes have passed after stimulation of uterine contractions, provided the uterus is contracted.

The three main causes of a retained placenta are: When the womb stops contracting, or doesn't contract enough for the placenta to separate from the wall of the womb. This is called uterine atony. This is called a placenta accreta, and is more likely if the placenta embeds itself over a previous caesarean section scar.

Manual extraction may be required if cord traction also fails, or if heavy ongoing bleeding occurs. Very rarely a curettage is necessary to ensure that no remnants of the placenta remain (in rare conditions with very adherent placenta such as a placenta accreta).

Join us now for Personalized Medical Education
https://www.medcampus.io/

Download medCampus app
Android: https://play.google.com/store/apps/de...
iOS: https://apps.apple.com/us/app/medcamp...