Retained Placenta
exp date isn't null, but text field is
ICD10 CODE: O73
Failure of delivery of placenta within 30 minutes of delivery of the baby.
Causes
- Poor management of 3rd stage of labour
- Failure of the uterus to contract
- Failure of the placenta to separate, e.g. if it is stuck in uterine muscle; placenta accreta
- Closing of the cervix before the placenta is expelled
Clinical feature
- The umbilical cord protrudes from the vagina
- Bleeding may be present (in partial separation)
- Uterus may be poorly contracted and high in the abdomen
- May be signs of infection, e.g. fever, unpleasant bloody dis- charge if the placenta is retained for long
Differential diagnosis
- Retained second twin
- Ruptured uterus
Investigations
- Blood: Hb, grouping and cross-matching
Management
Treatment | LOC |
If woman is bleeding, manage as PPH If the woman is not bleeding:
If placenta is not delivered in another 30 minutes
|
HC3 |
If unable to remove placenta manually
|
HC4 H |