The main health concerns with a retained placenta are the increased possibility of a postpartum haemorrhage or an infection of the uterus either from the interventions used to remove the placenta or on the occasion that a small part of the placenta is retained inside the uterus, after most of the placenta has been removed or delivered.
Postpartum haemorrhage
Infection of the uterus
Postpartum haemorrhage/p>
In a normal 3rd stage the uterus contracts after the birth of the baby to shrink in size, in order to help the placenta fully detach from the wall of the uterus. As the placenta separates the uterus continues to contract and retract to naturally stem the flow of blood that previously nurtured your baby. This process starts as soon as the placenta separates and is completed once the placenta is totally expelled from the uterus, continuing to take place as the uterus remains contracted after the placenta is delivered. The physiological action of this is discussed more fully in Class 7, dealing with the separation phase of the 3rd Stage.
If the placenta separates but remains inside the uterus, or only partially separates, the area where the placenta has detached from will bleed heavily until the placenta is expelled from the uterus. This is a retained placenta and can often lead to a postpartum haemorrhage (or PPH).
Infection of the uterus
Treatments for managing a retained placenta often involve the caregiver manually removing the placenta with their hand. This is explained later in this section in
medical interventions. This intervention can increase the risk of the woman experiencing an infection of the uterus.
Occasionally not all the placenta can be removed by the caregiver and a small lobe of the placenta (called a 'cotyledon'), about the size of a flat ping-pong ball, can be retained inside the uterus. Usually the woman's body is able to naturally expel the cotyledon in a blood clot that forms around it in the first few hours (or days) after the birth. In a few cases the cotyledon may be retained, causing an infection (and sometimes heavy bleeding). Treatments can include antibiotics and/or a curette, or a 'D & C'.