Placental Retention Definition, Reason, Symptoms, Treatment & Prevention
Definition
Placental retention is a condition of pregnancy in which the placenta cannot be separated from the uterine wall. In general, the placenta should detach from the uterine wall within 30 minutes after delivery.
In retained placenta, part or all of the placenta remains attached. This can make a woman who has just given birth lose excessive blood after delivery.
There are three types of retained placenta that can occur, namely:
- placenta adherent. Placenta adherents is the most common type of retained placenta. This occurs when the uterus fails to contract strong enough to expel the placenta.
- Trapped placenta. Trapped placenta occurs when the placenta detaches from the uterine wall but cannot leave the body. This often occurs when the cervix begins to close before the placenta is expelled, causing the placenta to become trapped behind it.
- Placenta accreta. Placenta accreta is a condition when the placenta attaches to the muscle layer of the uterine wall instead of the uterine wall. This often makes labor more difficult and causes heavy bleeding.
Placental Retention Symptoms
The most common sign of retained placenta is partial or complete failure of the placenta to leave the body within one hour of delivery. If the placenta stays inside, women in labor generally experience symptoms about one day after delivery. Symptoms of retained placenta that occur one day after delivery can include:
- Fever
- There is vaginal discharge that contains lumps of tissue
- Persistent excessive bleeding
- Persistent pain
Factors that can increase the risk of retained placenta are:
- Over 30 years old
- Delivered before 34 weeks of gestation, or premature labor occurred
- Have ever had a history of prolonged first or second-stage of labor
- Have had a history of stillbirths
Placental Retention Reason
Placental retention can be caused by many things, including:
- The implantation of the placenta in the inner wall of the uterus.
- Uterine contractions that are not strong enough to push the placenta out of the uterus.
- Partial or complete attachment of the placenta to the uterine wall.
- Placenta that has been detached from the uterus but cannot be removed from the body, due to the cervix that has begun to close.
Diagnosis
The doctor can make a diagnosis of retained placenta by carefully examining the integrity of the placenta that comes out of the vagina. The placenta has a characteristic shape.
The presence of a small part that is not complete is a clue that needs attention. However, in some cases, the doctor may not notice that a small part has detached from the placenta. When this occurs, it is common for the patient to show signs or symptoms soon after delivery.
If there is suspicion of a retained placenta, the doctor can perform an ultrasound examination to see the condition of the uterus. If a certain part of the placenta is missing, immediate treatment is needed to prevent complications.
Placental Retention Treatment
Treatment of retained placenta involves removal of the entire placenta or parts of it. This includes the following procedures:
- Expulsion of the placenta by hand by a health worker. However, this can increase the risk of infection.
- Using medication prescribed by a doctor that functions to relax the uterus or increase contractions. This can help the body expel the placenta.
- In some cases, breastfeeding is also effective in treating retained placenta. Breastfeeding encourages the release of hormones that increase uterine contractions.
- The doctor can also suggest urinating. Sometimes, a full bladder can prevent expulsion of the placenta.
- If this treatment cannot help this problem, surgery may be needed to remove the placenta or remaining tissue. However, because surgery always carries risks, this procedure is generally used as a last resort.
Prevention
Placental retention can be prevented by supporting complete expulsion of the placenta during the third stage of labour. These steps can be:
- Providing treatment that supports uterine contractions and expulsion of the placenta. Oxytocin is one type of treatment that can be given by doctors.
- Controlled stretching of the cord can be performed after the placenta is detached. While this is being done, the medical personnel holds the cord using clamps and stretches it without pulling it. This can support expulsion of the placenta after the baby is born.
- Stabilization of the uterus through touch during controlled cord stretching.