What are the symptoms of retained placenta?

Many people don’t know what retained placenta means. Normally, the placenta will come out within 5 to 10 minutes after a woman gives birth. However, if the placenta is not completely expelled and part of it remains in the woman’s uterus, this is called retained placenta. This is very harmful to women’s health, such as causing uterine bleeding and many other symptoms.

First, clinical manifestations

If bloody lochia lasts for more than 2 weeks and the amount is large, it often indicates that the placenta attachment site is not restored well or there are residual placenta and fetal membranes. If the lochia is not clear one month after delivery and is accompanied by a foul or rotten odor, or is accompanied by abdominal pain and fever, it may be an infection of the vagina, uterus, fallopian tubes, or ovaries. If it is accompanied by heavy bleeding and the uterus is large and soft, it often indicates that the uterus is poorly restored.

Second, the cause

It may be due to uterine malformation, uterine fibroids, intrauterine adhesions, etc., or it may be due to the unskilled operation operator, resulting in incomplete removal of the pregnancy tissue, causing some tissue to remain in the uterine cavity.

Third, diagnosis

1. Three weeks after delivery, red lochia is still discharged from the vagina.

2. If the lochia has a foul odor, or is accompanied by low fever, lower abdominal pain, poor uterine involution, or uterine tenderness, there is a uterine cavity infection.

3. When ultrasound examination shows that the uterus is poorly involuted and there is tissue in the uterine cavity, it is the placenta or placental residues.

Fourth, complications

1. Placenta adhesion

It is often manifested as prolonged third stage of labor or bleeding. The length of the third stage of labor has a significant relationship with the incidence of postpartum hemorrhage. When the third stage of labor lasts for more than 10 minutes, the amount of postpartum blood loss increases significantly, and when it lasts for more than 20 minutes, the increase in blood loss is more obvious.

2. Placental retention after detachment

It is mostly due to weak uterine contractions, weak abdominal muscles of the mother, or a full bladder, so that although the placenta has been completely detached from the uterine wall, it is retained in the uterine cavity, further affecting uterine contractions and causing bleeding.

Fifth, treatment

1. If the situation is not serious or no abnormalities occur temporarily, uterotonics and antibiotics can be used.

2. 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, a large blunt curette can be used to scrape it out. 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.

3. While taking effective hemostatic measures according to the cause of the disease, shock prevention and treatment must be actively carried out.

4. Prevent infection. Excessive blood loss may reduce the body's resistance, leading to puerperal infection or even sepsis, which is life-threatening. Therefore, large amounts of antibiotics should be given after delivery, and anemia should be actively corrected and nutrition should be strengthened.