Retained Placenta

Symptoms

Common signs and symptoms of Retained Placenta include:

Heavy bleeding from the vagina after delivery

Foul-smelling vaginal discharge

Fever or chills

Severe cramping or abdominal pain

Delay in milk production or breastfeeding difficulties

Fatigue beyond normal postpartum tiredness

Pieces of tissue passing from the vagina

Uterus that feels tender when pressed

Prolonged bleeding that soaks through pads quickly

Weakness or dizziness from blood loss

When to see a doctor

If you experience severe or worsening symptoms, seek immediate medical attention. Always consult with a healthcare professional for proper diagnosis and treatment.

Causes & Risk Factors

Several factors can contribute to Retained Placenta.

Causes

Retained placenta occurs when the normal process of placental delivery goes wrong. Normally, after the baby is born, the uterus continues to contract, causing the placenta to separate from the uterine wall and be expelled. This process relies on the placenta being attached in just the right way - not too shallow, not too deep. When the placenta attaches too deeply into the uterine muscle, a condition called placenta accreta occurs, making separation difficult or impossible without surgical intervention. Sometimes the placenta separates correctly but gets trapped inside the uterus because the cervix closes too quickly or uterine contractions become too weak to push it out. Risk factors that increase the likelihood of retained placenta include previous cesarean sections, which can create scar tissue that interferes with normal placental attachment. Advanced maternal age, preterm delivery, and certain medical conditions like fibroids can also contribute to this complication.

Risk Factors

Previous cesarean section or uterine surgery
Maternal age over 35 years
Preterm delivery before 37 weeks
History of retained placenta in previous pregnancies
Uterine fibroids or other structural abnormalities
Prolonged first or second stage of labor
Use of synthetic oxytocin during labor
Multiple pregnancies (twins, triplets)
Placenta previa or other placental abnormalities
Assisted delivery with forceps or vacuum

Diagnosis

How healthcare professionals diagnose Retained Placenta:

1
Diagnostic Process
Diagnosing retained placenta typically begins immediately after delivery when healthcare providers carefully examine the expelled placenta to ensure it appears complete. They look for missing pieces, tears, or unusual attachments that might indicate portions remain in the uterus. If the placenta hasn't delivered within 30 minutes of birth, or if there are signs of incomplete delivery, doctors will perform a physical examination. The diagnosis often becomes clear through clinical observation - heavy bleeding, pieces of tissue in vaginal discharge, or a uterus that doesn't contract properly are telltale signs. Healthcare providers may use ultrasound imaging to visualize the inside of the uterus and identify any remaining placental tissue. Blood tests can help assess the extent of blood loss and check for signs of infection. In some cases, the diagnosis becomes apparent days or weeks after delivery when a woman experiences prolonged bleeding, infection symptoms, or difficulty with breastfeeding that stems from hormonal disruptions caused by retained tissue.

Complications

The most immediate and serious complication of retained placenta is severe bleeding, which can lead to life-threatening hemorrhage requiring emergency treatment.
Infection is another significant risk, particularly when placental tissue remains in the uterus for extended periods, creating an environment where bacteria can multiply.
This can progress to serious conditions like endometritis or sepsis if not treated promptly.
Retained placental tissue can also interfere with normal hormonal changes after delivery, potentially affecting milk production and breastfeeding success.
Long-term complications may include the formation of scar tissue inside the uterus, which could affect future pregnancies or menstrual cycles.
In rare cases, emergency hysterectomy may be necessary to control bleeding or treat severe infection, ending a woman's ability to have future children.
However, with prompt recognition and appropriate treatment, most women recover completely without lasting effects.
The key is seeking immediate medical attention when symptoms develop, as early intervention typically prevents these more serious complications from occurring.

Prevention

Complete prevention of retained placenta isn't always possible since some risk factors like maternal age or previous surgeries cannot be changed.
However, proper prenatal care can help identify women at higher risk and ensure appropriate delivery planning.
During labor, allowing natural delivery processes to proceed without unnecessary intervention when possible may reduce risk, though medical interventions are sometimes essential for safety.
Active management of the third stage of labor, which involves giving medications to help the uterus contract and carefully controlling the delivery of the placenta, has been shown to reduce the risk of retained placenta in some cases.
Women with known risk factors should discuss their delivery plans with their healthcare team and ensure they deliver in a facility equipped to handle complications.
Maintaining good overall health during pregnancy, including proper nutrition and prenatal vitamin supplementation, supports optimal uterine function.
While these measures can't guarantee prevention, they help create the best possible conditions for normal placental delivery and ensure prompt recognition and treatment if complications arise.

Treatment Approaches

Treatment

Treatment for retained placenta depends on the severity and timing of the diagnosis. If detected immediately after delivery, doctors may first try manual removal, where they carefully insert a hand into the uterus to separate and extract the remaining placental tissue. This procedure is performed under anesthesia to minimize discomfort and requires careful technique to avoid injuring the uterine wall. When manual removal isn't successful or appropriate, a procedure called dilation and curettage (D&C) may be necessary, where doctors use special instruments to gently scrape away the retained tissue. For cases involving placenta accreta where the placenta has grown too deeply into the uterine wall, more extensive surgical intervention may be required. Antibiotics are typically prescribed to prevent or treat infection, especially if the retained tissue has been present for several days or weeks. In severe cases with life-threatening bleeding, emergency measures including blood transfusions or even hysterectomy may be necessary, though this is rare. Most women recover well with prompt treatment, and future pregnancies are usually unaffected unless there were complications requiring extensive surgery.

SurgicalAntibiotic

Living With Retained Placenta

Recovery from retained placenta treatment typically involves several weeks of healing, during which women need to monitor their physical and emotional well-being carefully. Following medical instructions about activity restrictions is crucial - this usually means avoiding heavy lifting, strenuous exercise, and sexual activity until cleared by a healthcare provider. Women should watch for warning signs like heavy bleeding, fever, or worsening abdominal pain and contact their doctor immediately if these occur. - Rest as much as possible while caring for a newborn - Take prescribed medications exactly as directed - Use pads instead of tampons until fully healed - Attend all follow-up appointments - Ask for help with household tasks and childcare Breastfeeding may be affected initially, but with support from lactation consultants, many women can successfully establish or re-establish milk production. Emotional support is equally important, as experiencing complications after childbirth can be frightening and overwhelming. Partners, family members, and healthcare providers play crucial roles in providing reassurance and practical assistance during recovery. Most women feel physically recovered within 6-8 weeks and can resume normal activities, though the emotional processing of the experience may take longer. Support groups for women who have experienced birth complications can provide valuable connection and understanding during the healing process.

Latest Medical Developments

Latest medical developments are being researched.

Frequently Asked Questions

How long after delivery can retained placenta be detected?

Retained placenta is usually detected within hours or days after delivery, but sometimes symptoms don't appear for several weeks. The condition is often diagnosed immediately if the placenta doesn't deliver within 30 minutes of birth.

Can I have more children after having a retained placenta?

Most women can have normal pregnancies after retained placenta, though you may be at slightly higher risk for recurrence. Your doctor will monitor future pregnancies more closely and plan appropriate delivery care.

Will retained placenta affect my ability to breastfeed?

Retained placental tissue can interfere with milk production initially, but most women can successfully breastfeed once the tissue is removed. Working with a lactation consultant can help establish or re-establish breastfeeding.

How much bleeding is normal after retained placenta treatment?

Light to moderate bleeding for up to 6 weeks is normal after treatment. However, heavy bleeding that soaks through a pad in an hour or less requires immediate medical attention.

What are the warning signs I should watch for during recovery?

Contact your doctor immediately for heavy bleeding, fever, chills, severe abdominal pain, or foul-smelling discharge. These could indicate infection or other complications requiring prompt treatment.

Is retained placenta more common with certain types of delivery?

Retained placenta occurs more frequently with vaginal deliveries than cesarean sections. Factors like prolonged labor, assisted delivery, or previous uterine surgery can increase the risk.

How is retained placenta different from normal postpartum bleeding?

Normal postpartum bleeding gradually decreases over several weeks, while retained placenta often causes persistent heavy bleeding, clots, or bleeding that stops and then restarts heavily after seeming to improve.

Can retained placenta happen if I had a cesarean section?

While less common, retained placenta can occur after cesarean delivery. Surgeons typically inspect the uterus during the procedure, but small pieces of tissue can occasionally be missed.

Will I need to stay in the hospital longer for treatment?

Hospital stay length depends on the treatment required and your recovery. Simple manual removal might not extend your stay, while surgical procedures like D&C may require additional monitoring time.

Are there natural ways to help expel retained placental tissue?

While some traditional remedies exist, retained placenta requires medical treatment and shouldn't be managed with home remedies alone. Prompt medical care is essential to prevent serious complications.

Update History

Mar 25, 2026v1.0.0

Published by DiseaseDirectory