Placental retention, when the placenta doesn't want to leave the uterus

Have you heard of retention or retention of the placenta? The definition of placental retention is a condition when the placenta does not separate itself from the uterus or there are things that make it difficult for the placenta to leave the body.

In fact, the placenta or placenta should come out of the mother's body by itself after giving birth. So, the uterus still contracts even though labor is over to expel the placenta.

So, what is the cause and how is the retention of placenta (placenta) treated? To find out more, see the following reviews.

What is placental retention?

Normally, the mother's body naturally pushes the placenta out after the baby is born.

The mother's uterus will contract, causing the placental membrane that is attached to the uterus to be released and eventually comes out.

This enters the phase or the third period of pregnancy in the process of normal childbirth.

Normal childbirth usually has a variety of delivery positions that can be adjusted according to the wishes of the mother.

However, if all or part of the placenta is still in the uterus after you give birth, this is called placental retention.

The definition of retention or retention of the placenta is a condition when the placenta is still in the uterus within 30 minutes after delivery.

Mothers are also said to have placental retention if the placenta does not come out for more than 30 minutes in a stimulated manner or if it is more than an hour naturally.

Retained placenta (placenta) is a condition that carries a risk of causing complications such as infection and heavy bleeding.

In fact, this one birth complication can also be fatal and threaten the mother's life if not handled properly.

What causes placental retention?

Launching from the American Pregnancy Association page, placental retention is a complication of childbirth that is divided into several types.

The division of each type of retention of the placenta which then causes the placenta not to come out of the uterus.

Specifically, the causes and types of retained placenta are as follows:

1.Adherent placenta (placenta adherens)

Adherent placenta is the most common cause of retained placenta.

Adherent placenta occurs when the uterus fails to produce enough contractions to expel the placenta completely.

Even though the uterus has contracted, all or part of the placenta is still attached to the uterine wall.

This results in the placenta remaining attached to the uterine wall.

2.The placenta is trapped (trapped placenta)

As the name implies, a trapped placenta is a type of placental retention when the placenta manages to escape but cannot get out of the mother's body.

Usually trapped placenta occurs when the cervix (cervix) begins to close after giving birth to a baby even though the placenta has not yet come out.

This trapped placenta is then left in the uterus.

3.Placenta accreta (placenta accreta)

Placenta accreta occurs when the placenta attaches too deeply to the muscle layer of the uterine wall, not the uterine wall.

This can make childbirth more difficult, often causing heavy bleeding.

Furthermore, the process of removing the placenta after giving birth is also much more difficult.

What are the symptoms of placental retention?

According to Pregnancy Birth and Baby, the main sign or symptom of retained placenta is when the placenta fails to fully expel from the uterus from one hour after birth.

Not only that, but sometimes you may just notice retention of the placenta after a few hours after giving birth.

Unconsciously, there is a small portion of the placental membrane remaining in the mother's uterus.

This small portion of the placental membrane will pass on its own from your body through the vagina.

The mother may feel stomach cramps before the blood clot comes out.

If the remaining placental membrane does not come out after a few days, here are the various symptoms of placental retention that the mother may also experience:

• Fever
• Heavy bleeding
• Abdominal cramps or pain that doesn't stop
• Odor-smelling vaginal discharge
• Exit a large piece of tissue through the vagina that comes from the placenta

If these signs occur in you after giving birth, you should immediately visit your midwife or doctor.

The midwife or doctor will find out the cause and further treatment if it is related to placental retention.

Who is at risk for placental retention?

In fact, any mother giving birth can experience placental retention.

The following are factors that can increase the risk of having retained placenta (placenta), namely:

• Pregnant over the age of 30.
• Delivered earlier before 34 weeks of gestation or experienced premature birth.
• There is a long time lag between the first and second stages of labor.
• Giving birth to stillbirths (stillbirth).

Removal of the placenta immediately after delivery is an important step in preventing retention of the placenta.

Besides being able to stop the bleeding that occurs during childbirth, removing the placenta immediately after giving birth can also make the uterus close properly.

If the placenta does not immediately leave the uterus, the blood vessels where the placenta is still attached will continue to bleed.

This then can cause bleeding, even the risk of causing postpartum bleeding or after childbirth.

If the mother has one or more of the risk factors above, consider giving a pregnant woman in a hospital rather than giving birth at home.

Do not forget, make sure that the mother has taken care of and tidied up all the preparation for childbirth and the equipment for childbirth in advance.

So, when later signs of childbirth appear, the mother can immediately go to the hospital accompanied by her husband or doula.

Signs of labor include labor contractions, rupture of the membranes, opening of labor, etc.

However, distinguish real labor contractions from false contractions.

How is retained placenta treated?

It should be noted that removal of the placenta which takes longer than 30 minutes can increase the risk of heavy bleeding and possibly lead to maternal death.

Placental retention is required if the process of expelling the placenta takes a long time or if some of the placenta is trapped in the mother's body.

The various methods that are commonly used to treat placental retention are as follows:

• The doctor may try to remove the placenta manually, but this carries a risk of infection.
• Giving drugs to relax the uterus so that it is able to contract to help the process of expelling the placenta.
• Breastfeeding can be considered as a treatment for retained placenta because it causes the uterus to contract which can help expel the placenta.

If the handling of removing the placenta is carried out naturally, the process may take longer and puts the mother at risk of heavy bleeding.

That is why doctors usually give injections to stimulate uterine contractions in order to encourage the placenta to expel.

After the injection, the doctor will wait for the placenta to come out completely without remaining in the uterus.

If the placenta is still retained, the doctor may give another injection according to the mother's condition.

The next step is that the doctor will see whether the placenta has completely or only partially separated from the uterine wall.

If only part of it, the doctor can pull the placenta out slowly.

Sometimes, the midwife or doctor needs to use a hand or a special tool to clean the remaining placenta from the mother's uterus.

This condition requires the mother to receive anesthesia so that certain parts of the body experience numbness.

However, removing the placenta by hand can increase the mother's risk of infection.

Surgical management of retained placenta

Treatment for placental retention complications can actually be done naturally by routine urination.

This is because a full bladder can block the process of expelling the placenta from the uterus.

However, if it does not work, the retention of the placenta needs to be taken with a surgical procedure.

The surgical procedure is carried out after the mother has finished giving birth by administering an epidural or anesthesia so that she does not feel anything.

Next, the doctor uses a device called a curette to scrape the uterine lining and clean the placenta.

Your doctor and medical team will always be watching to make sure you don't experience heavy bleeding after giving birth.

What are the possible complications of retained placenta?

Placental retention is one of several childbirth problems that can cause complications for the mother.

This complication can be in the form of heavy bleeding known as primary postpartum hemorrhage (PPH).

As previously explained, you can take surgery as a treatment for retained placenta.

It's just that, the surgical procedure involves administering anesthetic drugs so there is a risk of flowing with the milk.

Talk to your doctor to ensure the safety of the breastfeeding process later after the mother has had the placenta removal surgery.

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