What to do if the placenta does not come out after medical abortion

Medical abortion is a common method of terminating pregnancy. It uses drugs to promote the expulsion of the gestational sac. If the placenta is not expelled smoothly after taking the medicine, it means that part of it will remain inside the uterus. At this time, good treatment should be carried out in time, because this situation is relatively dangerous and can easily lead to heavy bleeding and infection. You should go to the hospital for examination and good treatment in time.

What to do if the placenta does not come out after medical abortion

If a small part of the placenta or fetal membrane remains in the uterus during placental retention and is not discovered at the time, it may also cause heavy bleeding and infection later. Retained placenta is a matter of life and death for the mother. Correct treatment of retained placenta is of great significance in preventing postpartum hemorrhage and reducing maternal mortality.

If for some reason the placenta does not fall off the uterus, it is called placenta accreta. People who have had multiple miscarriages or cesarean sections have a higher risk of placenta adhesion. In addition, about 10% of patients with placenta previa will develop placenta adhesion. If it is confirmed to be an accreta placenta, the doctor will take artificial measures to remove the placenta after delivery. If this still does not remove the placenta, surgery will be required to remove it or leave it in the body. The part of the placenta that remains in the body is called retained placenta, and the development of the disease must be closely monitored.

If the placenta has been detached from the uterine wall and has not been expelled, when the bladder is overswollen, you should first catheterize and empty the bladder. Then use one hand to massage the uterus to contract it and gently press the fundus of the uterus. Use the other hand to gently pull the umbilical cord to assist in the expulsion of the placenta.

If the placenta is adhered or the expelled placenta is defective, artificial placental separation should be performed to remove the placenta or residual placental tissue. If it is difficult to remove the residual placenta, it can be removed by scraping the uterus with a large blunt curette. If the placenta is incarcerated above the stenotic ring and is difficult to remove manually, it can be removed by dilating it with the fingers under general anesthesia.

If it is placenta accreta, hysterectomy is the safest method. Do not forcibly peel it off or remove it with your hands to avoid uterine perforation and fatal bleeding. For those who insist on retaining their fertility, the implanted part can be removed and the uterine wall can be repaired, or the placenta can be allowed to remain in the uterine cavity and wait for it to gradually dissolve and be absorbed or naturally expelled, but infection should be strictly controlled.

Placenta retention should prevent infection

Excessive blood loss may reduce the body's resistance, leading to puerperal infection or even sepsis, which is life-threatening. Therefore, in addition to paying attention to various aseptic operations during the rescue process, a large amount of antibiotics should be given after delivery, and anemia should be actively corrected and nutrition should be strengthened.