Placental remains in the uterus: symptoms and treatment

After childbirth, small remnants of the placenta may not be eliminated and remain stuck in the uterus, and it is important for the woman to be aware of some symptoms such as loss of a large amount of blood through the vagina, foul-smelling discharge, fever, cold sweat or weakness, for example.

Normally, the placenta is retained in the uterus due to insufficient uterine contractions, which means that the placenta is not completely eliminated after birth, with some pieces remaining attached to the wall of the uterus. However, this condition can also occur due to other factors, such as closing of the cervix before the placenta is removed or even a condition called placenta accreta, in which the placenta attaches to the muscle of the uterus instead of its lining. , making it difficult to leave.

When the placenta is retained in the uterus, bacteria can proliferate inside the uterus, which in more serious cases can reach the bloodstream and cause widespread infection, putting the woman’s life at risk. Therefore, if symptoms are present, you should contact your obstetrician immediately or seek the nearest emergency room.

Main symptoms

Some symptoms that may indicate the presence of placental remains in the uterus after childbirth are:

• Loss of large amounts of blood through the vagina;
• Loss of dark or viscous blood;
• Bad-smelling discharge;
• Fever above 38ºC;
• Dor abdominal;
• Dizziness;
• Cold sweat;
• Weakness.

If any of these symptoms appear, the woman should go quickly to the hospital to be evaluated and treated appropriately.

How to confirm the diagnosis

The diagnosis to confirm the presence of placental remains in the uterus is made by the obstetrician shortly after birth, visually examining the placenta after its removal to check whether or not it is intact. If it is not intact, the doctor can remove it manually or with the help of surgical forceps immediately.

However, in the event that some remnants of the placenta still remain in the uterus, the diagnosis is made through the presence of symptoms and an ultrasound to examine the uterus.

Possible causes

Most of the time, some remnants of the placenta may remain in the uterus when labor contractions were not strong enough to expel the entire placenta. However, this condition can also happen when the cervix closes before the placenta is completely delivered or when the placenta is attached to the muscles of the uterus instead of its lining, making it difficult to expel.

Furthermore, some factors can also contribute to the remains of the placenta remaining in the uterus, such as:

• Be over 30 years old;
• Premature birth before 34 weeks of gestation;
• Prolonged birth time;
• Baby who died before birth.

The remains of the placenta can remain attached to the uterus even after a cesarean section and sometimes it is enough for a very small amount to remain, such as 8mm of placenta, for there to be major bleeding and uterine infection. Know how to identify the symptoms of an infection in the uterus.

How the treatment is carried out

The treatment to remove the remains of the placenta from the uterus is carried out by the obstetrician by removing the placenta or any part that remained in the uterus immediately after birth, removing it manually or with the help of surgical instruments. However, the doctor may also use medicines to relax the wall of the uterus or make it contract, such as misoprostol or oxytocin, facilitating the expulsion of the placenta.

To remove the remains of the placenta, the doctor may also perform an ultrasound-guided uterine curettage, which completely removes all remains of the placenta, in addition to recommending the use of antibiotics to treat any possible infection that is already developing in the uterus. See what uterine curettage is and how it is performed.

In the case of placenta accreta, the doctor may also recommend a blood transfusion due to intense bleeding or even surgery to remove the uterus, called a hysterectomy. Understand how hysterectomy is performed and what recovery is like.