How the placenta is delivered

The delivery process is not only about the safety of mother and child, but also about the placenta being completely separated from the mother's body. There are always some mothers whose placentas cannot be completely delivered, and some remaining tissues are in the uterus. Over time, they are prone to infection and may even cause some inflammatory problems. Therefore, the correct way to deliver the placenta should be introduced to everyone. In addition, you also need to know how to correctly deal with the residual placenta.

About retained placenta

Under normal circumstances, for a woman who gives birth naturally, the placenta will be delivered intact from the birth canal within 5-15 minutes after the fetus is delivered, and at the latest within 30 minutes. If the placenta is not completely delivered from the mother's body and some tissue remains inside the mother's uterus, it is called postpartum placental retention.

The dangers of retained placenta

During the third stage of labor, the uterus shrinks significantly after the placenta is delivered normally, and the contraction of the uterine muscles plays a role in compressing and stopping bleeding. When the placenta is retained, uterine contraction is restricted and the blood sinuses at the placenta attachment site open, causing intrapartum and postpartum bleeding.

If the placenta remains in the uterine cavity for too long, the remaining placental tissue will degenerate, necrotize, and ossify, and form placental polyps. When the necrotic tissue falls off, the blood vessels at the base of the placenta are exposed, causing heavy bleeding. Therefore, retained placenta is also one of the main causes of late postpartum hemorrhage.

In addition, retained placenta increases the risk of postpartum infection and worsens the patient's condition. The clinical manifestations may be persistent small amounts of vaginal bleeding, repeated bleeding, or heavy bleeding at one time. Retained placenta not only seriously affects postpartum recovery and increases maternal pain, but also has a serious adverse impact on their quality of life.

Diagnosis of retained placenta

The clinical manifestations of retained placenta vary. Mild cases may include intermittent or sudden small amounts of vaginal bleeding and secondary anemia after delivery. Physical examination may reveal softening and relaxation of the cervical opening, softening of the enlarged uterus, poor uterine involution, and obvious lower abdominal tenderness in patients with intrauterine infection. Severe cases may be life-threatening due to massive bleeding. When the clinical symptoms of retained placenta are atypical, it is easy to be missed.

B-ultrasound examination has great diagnostic significance and value. When the placenta is retained, the main manifestation of B-ultrasound examination is sparsely scattered light spots, light spots or light groups of different shapes in the uterine cavity. The intensity, size, shape and position of the light group echo vary depending on the nature of the residues in the uterine cavity and the degree of necrosis.

Retained placenta should be differentiated from placenta accreta, placenta accreta, and intermediate trophoblastic disease. The key points for distinguishing placenta accreta and placenta retention on B-ultrasound are: the number of blood sinusoids in the placenta, whether there is a retroplacental space, the thickness and integrity of the muscle layer at the placental implantation site, and whether the vesicouterine pouch is intact.