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). There is currently uncertainty about the effectiveness of anaesthesia or analgesia for manual extraction, in terms of pain and the risk of postpartum haemorrhage. Manual extraction may be required if cord traction also fails, or if heavy ongoing bleeding occurs. 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. However, ergometrine should not be given as it causes tonic uterine contractions which may delay placental expulsion. It is useful ensuring the bladder is empty. Management ĭrugs, such as intraumbilical or intravenous oxytocin, are often used in the management of placental retention. A retained placenta thereby leads to hemorrhage. If the placenta only partially separates, the uterus cannot contract properly, so the blood vessels inside will continue to bleed. After the placenta is delivered, the uterus should contract down to close off all the blood vessels inside the uterus. Risks of retained placenta include hemorrhage and infection. 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. placenta separated from the uterine lining but retained within the uterusĪ retained placenta is commonly a cause of postpartum haemorrhage, both primary and secondary.failed separation of the placenta from the uterine lining.Retained placenta can be broadly divided into: Retained placenta is a condition in which all or part of the placenta or membranes remain in the uterus during the third stage of labour.
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