Retained Placental Fragments
Definition - What does Retained Placental Fragments mean?
Retained placental fragments are when parts of the placenta remain inside the uterus after vaginal or cesarean delivery or termination of pregnancy through medical abortion or miscarriage. Retained placental fragments can be immediately life-threatening to the mother due to heavy vaginal bleeding. If not completely evacuated, the placental fragments can cause uterine infections and scarring which can lead to long-term complications that can cause infertility.
Retained placental fragments are also called retained products of conception.
FertilitySmarts explains Retained Placental Fragments
The placenta is an organ that develops during pregnancy. It attaches to the inside of the uterine wall and is connected to the fetus via the umbilical cord. Exchange of oxygen and nutrition to the fetus and removal of waste products from the fetus occur through the placenta.
The placenta begins to develop as early as 7 days after fertilization and usually completes its development by the end of the 14th week. The placenta then continues to grow in size to meet the increasing demand of the developing fetus. Termination of pregnancy, either due to the vaginal or cesarean delivery of the baby, abortion or miscarriage is typically followed by complete evacuation of the placenta.
Rarely, the whole placenta or fragments of it may fail to exit the uterine cavity. This can be due to abnormal adherence of the placenta to the uterus or abnormal contractions of the uterus after delivery. Retained placental fragments can lead to persistent vaginal bleeding and passage of clots. Infection is a long-term complication and women may develop fever, abdominal pain and a vaginal discharge with or without particles/clots.
If retained placental fragments are suspected, an ultrasound scan is done to confirm the diagnosis. If fragments are seen in the uterus, they need to be removed immediately to prevent complications. Medications like syntometrine, ergometrine, and oxytocin stimulate contractions of the uterus which aids the evacuation of the placental fragment. If medical treatment fails, retained placental fragments are removed either vaginally using the hand or instruments or surgically.