Retained placenta

As Plazentaretetion (Latin Retentio placentae ) is in obstetrics Nichtausstoßung, comportment of the placenta, or parts thereof, named after the birth. It occurs in about one in 300 births. In veterinary medicine, this is referred to as retained placenta ( afterbirth ).

Causes

The retention of the placenta may have some functional and pathological- anatomical causes ( implantation disorders). On the one hand can prevent the placenta and fetal membranes are expelled a spasm of the internal os. The placenta is " trapped " and therefore called placenta incarcerata.

Another reason for a delay or lack of afterbirth may be a lack of resolution of the placenta from the uterine wall. Insufficient shear forces at too low uterine contraction, as well as to smaller attack surface membranous due to a small placenta or placenta may lead to failure of the right solution adhering placenta. In addition, the decidua basalis, the thin Spongiosaschicht missing. Thus it comes to the placenta adhaerens.

Finally, adhesions between the placenta and uterine wall may be other causes of Plazentaverhaltung. It is to the implantation disorders such as placenta accreta in the varying degrees of severity.

Symptoms

The removal of the placenta characters appear differently. While the characters in the clamped placenta are positive, they remain negative in the other forms. In addition, it may lead to abnormal bleeding from the uterus, as these can not contract enough at lying Plazanta.

Treatment

Labor -enhancing drugs cause a contraction of the uterus and promotes the solution of the placenta. The emptying of the maternal urinary bladder, a slight rubbing of the uterus and a short-term cold stimulus also promote contraction of the uterus. If necessary, the Credé handle can also be performed. In placenta incarcerata anticonvulsants may cause spasm of the solution. If these measures are not successful, is necessary as with the other forms, manual removal of the placenta under anesthesia.

In extreme cases of placenta increta / percreta, a hysterectomy may be necessary, since this does not remove the placenta parts.