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Your delivery does not end when the baby is born. There is another critical phase of the work, which is the third stage of labor. The body expels the placenta and the membranes after the birth of the child, and easily slide out through the vagina. It is a step on that takes nearly 10 to 20 minutes and, at times can extend up to an hour.
In less developed countries, which affects about 0.1% of the births and is associated with mortality up to 10%. In most developed countries, it is common, but the mortality rate is very low. E 'it was also identified that has kept the placenta is one of the major obstetric hemorrhage causes (1)
[Read: 3 stages of childbirth ]
What is retained placenta?
Your body expels the placenta within one hour of birth of your child. But if part or all of the placenta and its membranes do not expel more than one hour of birth, it is known as a retained placenta. It happens to the third stage of labor.
you can have a physiological or a third run stage.
- Physiological third phase plan to deliver the placenta by pushing everything out of himself.
- Managed third stage is when the health care provider gives an injection to the thigh at the time of child birth or shortly thereafter. It causes a decrease in your uterus and push out your placenta and membranes. Usually it is completed in 5 to 10 minutes. A third phase will lower run the risk of bleeding after the birth of your baby.
The doctor will treat the placenta considered only if doubts that a placenta or membrane is still attached to the uterus. The placenta is examined after delivery of your baby, but managed third stage is usually taken then
of placental retention causes :.
The primary causes of retained placenta are as follows:
1. Uterine Atony :.
In this case, the uterus contraction ceases or does not contract enough to separate the placenta from the wall of
2. Adherent Placenta:
In rare cases, a part or the entire placenta is deeply embedded in the uterine wall and can not break away from uterus.
3. Placenta accreta:
placenta accreta is a rare but serious condition in which part of the placenta adheres to a scar on uterine muscle instead of the coating. This condition may occur in women who have scarring on the uterine muscle from previous caesarean sections. Percreta placenta if the placenta has spread through the wall of the uterus.
4. Trapped Placenta:
Trapped placenta is a condition in which the placenta separates from the uterine wall successfully, but can not pass through the cervix, which is semi-closed. A trapped placenta could also occur during a cable controlled contraction in the third phase. The umbilical cord will snap back if pulled too hard or too thin, leaving the placenta within the uterus.
Some Other rare causes of retained placenta are:
5. The full bladder:
A full bladder will not allow the uterus to contract properly, possibly preventing delivery placenta. In this case, the doctor will help to drain the bladder through a catheter.
6. 'Fiddling' with the uterus.
Action, like massage or rub the uterus before the third phase will cause weak, irregular contractions that lead to partial separation of the placenta
7. A uterus bicornis:
bicorne uterus is a uterus in a heart shape. This tissue extends into the uterus pregnancy before giving him a heart shape. If the placenta is attached to the fabric, you will not be able to log off from the uterine wall.
8. A Succenturiate lobe:
a succenturiate lobe is a small piece of placenta is attached to the royal placenta through a blood vessel. This lobe is usually left behind the placenta which could lead to a possible retained placenta.
9. Emotional reactions:
overwhelming emotional reactions such as fear or helplessness during childbirth could trigger the release of adrenaline and stop the release of oxytocin, eventually stopping the contractions to release the placenta
Risk factors that cause. retained placenta:
Certain factors may put you at risk of retained placenta. They are as follows:
- Getting pregnant after age 30
- premature birth or birth before reaching the 34th week of pregnancy [
- previous cases of retained placenta.
- give birth to a stillborn child.
- prolonged first or second stage of labor.
- Any previous uterine surgery.
symptoms of retained placenta after the baby is born:
If a small portion of the placenta remains inside the womb, passing through the vagina alone. You will experience stomach cramps before passing a clot. It may be the remaining placental tissue. You should tell your doctor if this is happening. In this case, you can check your breasts in order to ensure the presence of retained placental tissue.
If these remains do not eject out of the vagina, you can develop the following symptoms:
- Fever
- Heavy bleeding
- drain smelly
- stomach cramps
- low content of breast milk
If you experience any of the above symptoms placenta earnings, especially heavy and prolonged bleeding after the birth of your child, you should immediately check with your doctor. You can suggest to go for an ultrasound scan to see if any retained placental fragments are present in your lap.
you can do anything to help separate the placenta?
If the third phase of the work is taking time, you should try to breastfeed her little or rub your nipples so that the hormone oxytocin release. It causes contractions in the uterus and helps you deliver the placenta and membranes. You should also try to change position, rotating in a vertical position so that gravity also helps to expel the placenta.
If you go through a physiological third stage of labor, and the placental delivery will not happen in an hour, go for managed third stage. Doctor gives an injection of oxytocin that helps the uterus to contract. In addition, your doctor will help you pull out the placenta.
If the placenta is still inside and not even out your doctor will give you another injection of oxytocin after managed third stage. Along with oxytocin, she will also inject saline into the umbilical vein to help expel the placenta.
How is retained placenta treated?
If the placenta is not ejected after the injection of saline and oxytocin, the doctor may opt for subsequent treatments.
1. Manual removal of placenta (MROP):
MROP is the most common practice for the treatment of retained placenta. The midwife or doctor removes the placenta with your hands after administering the spinal or epidural anesthesia. The health care worker waits for 30 to 60 minutes before resorting to MROP because 40% of the placenta usually comes out during this time, with a loss of 300 ml of blood. Otherwise, the doctor will gently put his hand into the uterus to remove the placenta and membranes. It will also be given intravenous antibiotics to prevent further infection and help the uterus to contract down.
This retained placenta treatment procedure, you may be exposed to anesthetic risks and also infections that may arise through the insertion of hands into your body. Also, you can not feed the baby immediately because medications can infect the milk.
2. Curettage:
For acreta placenta, manual removal is done partially, and curettage removes the rest. According to this method, a curette is used to remove tissue from the uterus through the demolition.
retained placenta does not cause problems?
After delivery of the placenta, the uterus contracts so that all the blood vessels are closed inside. But in the case of retained placenta, where only partially separates, the uterus does not contract completely. This causes the blood vessels to bleed continuously and can lead to postpartum hemorrhage primary (PPH) or secondary PPH
primary PPH -. If the managed third stage takes more than 30 minutes after his child delivery, the risk of bleeding increases. severe bleeding in the first 24 hours after birth is the primary post-partum haemorrhage (PPH).
You are having primary PPH if you bleed more than 500 ml within 24 hours of delivery. Is less PPH if the estimated blood loss up to 1000 ml and important PPH if the loss is greater than 1,000 ml
secondary PPH -. If there are remains of placenta and membranes, and also lacks the doctor to remove them, can cause bleeding, as well as the infection in the next step. It is bleeding that might happen after 24 hours and up to six weeks after delivery. It is a rare event.
is preventable retained placenta?
The birth is unpredictable, so it is not easy to reduce the risk of rare complications such as retained placenta.
- If you have experienced a retained placenta in a previous delivery, then there is a greater risk of another. You should inform your doctor so that she will be very closely during the third stage of labor.
- Keeping mother and baby together, skin to skin contact will help reduce the risk of retained placenta.
- Avoid frequent oxytocin inductions in order to reduce the risk of retention, C-section placenta and the uterine scar. Too oxytocin it will lead to uterine atony, which is once again an important cause for the retention of the placenta.
The choice of health care provider can definitely help you stay away from complications with valuable treatments.
Moms, did you see your acquaintances you experience this? How you've arranged it? We would love to hear from you. Please share your comments in the section below
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