What happens if the afterbirth doesn’t come out?
Introduction
After giving birth, most women experience the delivery of the placenta, which is also known as afterbirth. This process can be a significant milestone, signaling the end of a long and laborious birthing process. However, in some cases, a portion of the placenta may remain inside the woman’s uterus, a condition known as retained placenta. In this article, we will explore what happens if the afterbirth doesn’t come out and how it can affect a new mother’s health.
What is a retained placenta?
A retained placenta is a type of complication that occurs in about 1 in every 100 deliveries. This condition occurs when a piece of the placenta detaches from the uterine wall but fails to be expelled from the mother’s body. This may happen due to various factors, including uterine trauma, retained fragments, or inadequate contractions to expel the placenta.
Symptoms
If a portion of the placenta remains inside the uterus, the woman may experience some symptoms, such as:
• Heavier bleeding: The womb continues to bleed, potentially leading to excessive blood loss, which can be dangerous if left untreated.
• Pain: Pelvic pain, cramps, or a feeling of heaviness in the vagina may occur as the blood clots or the fragments of the placenta release hormones.
• Difficulty with breastfeeding: If breastfeeding is attempted before the removal of the retained placenta, it may be complicated or even impossible due to the presence of the tissue fragments.
• Anxiety and distress: Expectant mothers may experience a sense of anxiety, disappointment, or even distress, which can impact their recovery and overall well-being.
Complications
Retention of the placenta may lead to various complications if left untreated, including:
• Infection: Bacteria can enter the uterus and cause infection (endometritis), leading to fever, chills, and pelvic pain.
• Heavy bleeding: The risk of heavy bleeding increases, potentially leading to hemorrhage and even require emergency surgery.
• Septic shock: Bacteria can enter the bloodstream, causing septic shock, which is a potentially life-threatening condition.
• Long-term health implications: Retained placenta can lead to chronic postpartum hemorrhage or recurrent endometritis in subsequent pregnancies.
Diagnostic methods
Healthcare professionals may use the following methods to diagnose a retained placenta:
• Bimanual examination: Physical examination of the uterus is performed to detect any fragmentation or irregularity.
• Ultrasound: Using ultrasound technology, healthcare professionals can visualize the uterus to detect any retained placental tissue.
• Symptom assessment: Healthcare providers carefully assess the mother’s symptoms, such as bleeding or pain, to determine whether a retained placenta might be present.
Treatment
Treatment for a retained placenta usually involves pharmacological and/or surgical measures, including:
• Oxytocin medications: Medications such as Pitocin are often given to stimulate contractions to help expel the remaining placental tissue.
• Manual removal: Health care providers may perform manual removal of the placenta using a speculum.
• Surgical exploration: In cases where bleeding or infection persists, surgeons may perform a surgical procedure to remove the retained tissue.
• Antibiotics: In cases where infection is suspected, healthcare providers may prescribe antibiotics.
Prevention
Pregnant women can minimize the risk of retained placenta by:
• Proper care during the birthing process: Monitor the mother’s contractions and ensure that the fetus is delivered before attempting to deliver the placenta.
• Monitoring for incomplete placental delivery: Women should be monitored closely in the postpartum period to detect any signs of incomplete placental delivery, such as persistent bleeding.
• Breastfeeding promotion: Immediate postpartum lactation promotes delivery of prolactin and aids the separation of the placenta.
Conclusion
While retained placenta is relatively rare, it can significantly impact a new mother’s health and recovery. Pregnant women should be informed about the risk factors, symptoms, and treatment options for retained placenta, ensuring that they receive necessary care and attention during this critical period.