Medical Q&As

Placenta - retained?

Can retained placenta be serious?

Normally the placenta or afterbirth is expelled from the womb within half an hour of the baby being born. If the placenta has not been expelled within an hour of the birth taking place it is usually removed manually under a general anaesthetic. If it were not removed serious haemorrhage could result. Sometimes the placenta can be expelled but a few fragments of it may be retained, which could give rise to later haemorrhage or even infection within the womb. For this reason the placenta is always inspected after birth in order to establish that it is fully intact. The whole placenta is usually retained because of “atony” or lack of tone in the uterine muscles, which simply means that the womb lacks the power to push the placenta out. The drug Syntometrine is usually used during the active management of labour in order to prevent such atony and also to assist in the expulsion of the placenta. Retention can also happen if the womb ruptures during labour, which is a rare event. There can also be special circumstances whereby the placenta has adhered excessively strongly to the wall of the womb. This could result from the chorionic villi in the placenta penetrating through the superficial inner layer of the womb and into the deeper muscle layers. In this scenario the placenta is literally embedded in the wall of the womb and cannot be expelled even if the muscle tone in the womb is strong. Such events are also rare.