retained placenta

We all know that we can come across many complications during pregnancy, and not all of them are related to the baby. There can be placental problems as well, like having a retained placenta.

Have you ever heard about this pregnancy complication? Don’t worry, because we’re going to explain all about it. Don’t miss the following lines!

  

What is a retained placenta? 

As you probably know, the placenta is the organ that helps transmit and filter the nutrients and the oxygen between mummy and baby – and, once pregnancy is over, it’s not necessary anymore. As a consequence, mummy will deliver the placenta right after giving birth to the baby (third stage of labour). 

However, the delivering of the placenta can cause some complications as well. Sometimes, the placenta or part of it will stay inside mummy’s womb: this is what it means to have a retained placenta.

 

What are the symptoms of retained placenta?

Sometimes, especially when only a part of the placenta stays inside, you will expel it little by little. Most times, the situation will resolve itself and you will pass that small piece in little clots of remaining tissue. You may feel painful cramps when doing so. 

If your womb isn’t expelling the pieces of retained placenta itself, you will feel other more dangerous symptoms. Tummy cramps will keep happening, but you could also have a fever, smelly vaginal discharge or heavy bleeding. Besides, your milk may not come up, since having a retained placenta may be giving mixed signs to your body.

Whether you’re expelling the retained placenta or not, you should call your doctor or midwife. If you are, the midwife will want to check up on you to see if your uterus is fully contracted and that there is no placenta left inside. If you aren’t, they will need to perform an ultrasound to see what is going on.

 

What causes it? 

There are several reasons why you may have a retained placenta, like the following:

  • Uterine atony: It’s one of the main causes, and it happens when the uterus isn’t contracting enough after delivering the baby. Without this extra effort from your uterus, it is possible that the placenta stays inside.
  • Trapped placenta: This happens if your cervix is semi-closed after delivering the baby, since it may prevent you from actually passing it through, even if it has been detached.
  • Adherent placenta: One of the most common causes of retained placenta. It happens when this organ doesn’t fully detach from your uterine walls. It is not the same as placenta accreta (in that case, the placenta has embedded in the womb), but, of course, they are closely related.
  • Uterine abnormalities: Some abnormally shaped uterus (like bicornuate uterus) can also provoke a retained placenta.

Besides, there are also some risk factors worth considering, like the induction of labour, premature birth or having given birth several times before.

 

How is retained placenta treated?

If you have a retained placenta, there are some things that can be done when you are still in the delivery room. The third stage of labour, that is, the delivering of the placenta, can happen in two different ways: naturally, or induced (you can discuss your options with your midwife first and write it on your birth plan).

If you decide to deliver the placenta physiologically, your midwife will wait for your womb to start contracting naturally once the baby is born. If you decide that the doctors should manage it instead, they will give you a shot of synthetic oxytocin as your baby is being born, which will help your womb contract.  

If you are not delivering the placenta, you will be offer an extra (or a first) shot, and your midwife will observe you, since there will be a risk of bleeding. This will happen 30 minutes after the birth if you’ve had the injection before, and an hour after the birth if you decided to deliver the placenta naturally.

Unfortunately, if the injection doesn’t work, the doctor will have to try to remove it manually, which can be overwhelming, especially after giving birth. They will use a spinal anaesthetic or an epidural to numb the area, and, once it’s done, the doctor will remove the placenta and remaining membranes with their hand. Having this procedure will mean that they will have to inject antibiotics and other medicines so your womb contracts.

You can ask for them to give you a general anaesthetic if you don’t want to be awake during the procedure, but keep in mind that this entails extra risks for you. Besides, you will have to wait for breastfeeding your baby, which may pose problems for establishing breastfeeding.

  

Can I prevent having a retained placenta a second time?

Sadly, no. Besides, you need to consider that if you’ve had a retained placenta before, you may need to relive the situation in a subsequent pregnancy.

But there are some things that you can do that may indirectly help you prevent it. Keep in mind that if you decide to deliver the placenta naturally, without the oxytocin, you are less likely to suffer from a retained placenta. Besides, by avoiding unnecessary C-sections and thus uterine scars, you will have less chances of having it.

  

Retained placenta doesn’t usually entail more serious complications, although it can be overwhelming to have to deal with it when all you want to do is to be with your baby. But have a little bit more of patience and it will soon be over!