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A retained placenta is a placenta that does not undergo expulsion within a normal time limit. Risks of retained placenta include hemorrhage and infection. If the placenta fails to deliver in 30 minutes in a hospital environment, manual extraction may be required if heavy ongoing bleeding occurs.
Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the "four Ts": [12] Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding. Retained placental tissue and infection may contribute to uterine atony.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Bloody show or show is the passage of a small amount of blood or blood-tinged mucus through the vagina near the end of pregnancy.It is caused by thinning and dilation of the cervix, leading to detachment of the cervical mucus plug that seals the cervix during pregnancy and tearing of small cervical blood vessels, [1] and is one of the signs that labor may be imminent. [2]
Placental expulsion can be managed actively or it can be managed expectantly, allowing the placenta to be expelled without medical assistance. Active management is the administration of a uterotonic drug within one minute of fetal delivery, controlled traction of the umbilical cord and fundal massage after delivery of the placenta, followed by ...
A retained placenta is commonly a cause of postpartum haemorrhage, both primary and secondary. [1] 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. [2]
Sequence of images showing the stages of a normal vaginal delivery (NVD) Sequence of images showing stages of an instrumental vaginal delivery. A vaginal delivery is the birth of offspring in mammals (babies in humans) through the vagina (also called the "birth canal"). [1] It is the most common method of childbirth worldwide. [2]
Immediately after delivery, the fundus of the uterus begins to contract. This is to deliver the placenta which can take up to 30 minutes and may involve a feeling of chills. [8] In a normal and healthy response it should feel firm and not boggy. It begins to involute with contractions of the smooth muscle of the uterus. It will contract midline ...