What Is a Retained Placenta?

30 minutes after the birth of the fetus, the placenta has not yet delivered, known as placental retention, is an important cause of postpartum hemorrhage. However, if the placenta is not completely stripped from the uterine wall, although the placenta is retained, there may be no bleeding for a period of time. Therefore, it is of great significance to properly handle placental retention to prevent postpartum hemorrhage and reduce maternal mortality.

Placental retention

1. Placental incomplete peeling: more common in

Diagnose based on

1.

Placental retention treatment principles

1. Hemostasis, if the placenta has been stripped from the uterine wall and not discharged, the urinary bladder should be catheterized and the bladder emptied, and then the uterus is massaged with one hand to contract it, and the uterine cord is gently pressed, and the umbilical cord is gently pulled with the other hand To assist the discharge of the placenta. If the placenta is stuck or the discharged placenta is defective, the placenta should be removed manually to remove the placenta or the remaining placental tissue. If it is difficult to remove the remaining placenta, it can be removed with a large blunt curette. If the placenta is incarcerated above the narrow ring and it is difficult to remove it by hand, it can be removed by expanding the finger under general anesthesia. If it is an implanted placenta, hysterectomy is the safest, and it should not be removed by barely peeling by hand to avoid causing uterine perforation and fatal bleeding. Those who persist in reproductive function can remove the implanted part and trim the uterine wall or leave the placenta in the uterine cavity, and wait for it to gradually dissolve, absorb or naturally discharge, but strictly control the infection.

2. While carrying out effective hemostatic measures according to the cause, the prevention and treatment of shock must be actively carried out.

3. Anti-infection Maternal infection due to excessive blood loss can reduce the body's resistance, and the production of mattress infections, or even sepsis, is life threatening. Therefore, in the rescue process, in addition to attaching importance to various aseptic operations, a large number of antibiotics should be given postpartum, and anemia should be actively corrected to strengthen nutrition.

Placenta retention medication principles

1. For patients with acute bleeding, try to give whole blood as much as possible to supplement blood volume. If it is difficult to replenish whole blood temporarily, plasma substitutes can be used instead of medium molecular dextran and albumin.

2. Placental retention leads to postpartum hemorrhage, coupled with intrauterine operation, which is prone to puerperal infections. Therefore, cyanin should be selected according to the situation to prevent infection. If the infection is more likely, cyanamide should be added at the same time as cyanin Kanasin enhances the antibacterial effect of antibiotics.