Retained placental tissue

Retained placental tissue, also known as retained products of conception (RPOC), occurs when some part of the placenta or fetal membranes remains in the uterus after childbirth or a miscarriage. Normally, the entire placenta should be delivered shortly after the baby is born. When pieces of the placenta or membranes are not expelled from the uterus, it can lead to various complications.

Causes:

  1. Incomplete Placental Delivery:
  • In some cases, the placenta does not separate and deliver completely from the uterine wall after childbirth.
  1. Miscarriage:
  • After a miscarriage, some tissue may be retained in the uterus.
  1. Dilation and Curettage (D&C):
  • Procedures such as D&C, commonly performed after a miscarriage or abortion, can sometimes leave behind residual tissue.
  1. Medical Termination of Pregnancy (MTP):
  • Similar to D&C, medical methods of abortion may result in retained placental tissue.
  1. Abnormal Placental Attachment:
  • Conditions like placenta accreta or placenta previa, where the placenta is abnormally attached to the uterine wall, may increase the risk of retained placental tissue.

Symptoms:

  1. Persistent Vaginal Bleeding:
  • Continuous or irregular bleeding beyond the normal postpartum or post-miscarriage period.
  1. Pelvic Pain:
  • Pain or discomfort in the pelvic region.
  1. Foul-Smelling Discharge:
  • An unpleasant odor in vaginal discharge may indicate an infection associated with retained tissue.
  1. Fever:
  • Infection resulting from retained tissue may lead to fever.

Diagnosis:

  1. Clinical Examination:
  • Healthcare providers may perform a pelvic exam to check for signs of retained placental tissue.
  1. Ultrasound:
  • Transvaginal ultrasound can help visualize the inside of the uterus and identify any remaining tissue.
  1. Blood Tests:
  • Blood tests, including a complete blood count (CBC) and tests for infection markers, may be conducted.

Treatment:

  1. Manual Removal:
  • In some cases, manual removal of retained tissue may be performed by a healthcare provider.
  1. Dilation and Curettage (D&C):
  • This surgical procedure involves scraping the uterine lining to remove any remaining tissue.
  1. Medication:
  • Medications such as misoprostol may be used to help the uterus expel retained tissue.
  1. Antibiotics:
  • If an infection is present, antibiotics may be prescribed.

Complications:

  • Untreated retained placental tissue can lead to infections, persistent bleeding, and other complications that may affect the woman’s health and fertility.

Follow-Up:

  • Close follow-up with a healthcare provider is essential after treatment to monitor recovery and address any lingering issues.

If a woman experiences symptoms suggestive of retained placental tissue, it’s crucial to seek medical attention promptly. Early diagnosis and appropriate management are essential for preventing complications and ensuring the woman’s well-being.