Risks of retained placenta include hemorrhage and infection. After the placenta is delivered, the uterus should contract down to close off all the blood vessels inside the uterus. If the placenta only partially separates, the uterus cannot contract properly, so the blood vessels inside will continue to bleed. A retained placenta thereby leads to hemorrhage.
Stimulation of uterine contractions by an intraumbilical or intramuscular oxytocin injection appears to be a useful and inexpensive non-surgical and non-aggressive method of inducing placental expulsion. It is also useful ensuring the bladder is empty. However, ergometrine should not be given as it causes tonic uterine contractions which may delay placental expulsion. Controlled cord traction has been recommended as a second alternative after more than 30 minutes have passed after stimulation of uterine contractions, provided the uterus is contracted. Manual extraction may be required if cord traction also fails, or if heavy ongoing bleeding occurs. Very rarely a curettage is necessary to ensure that no remnants of the placenta remain (in rare conditions with very adherent placenta such as a placenta accreta).
However, in birth centers and attended home birth environments, it is common for licensed care providers to wait for the placenta's birth up to 2 hours in some instances.
- Placenta (retention)
- Maternity - Prevention, Early Recognition & Management of Postpartum Haemorrhage (PPH) From Department of Health, NSW. 21-Oct-2010
- Habek, D; Hrgović, Z; Ivanisević, M; Delmis, J (2001). "Treatment of a retained placenta with intraumbilical oxytocin injection". Zentralblatt fur Gynakologie 123 (7): 415–7. PMID 11534303.
- Retained Placentas