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Case 61 - A 30-Year-Old with an Undelivered Placenta 30 Minutes Following Delivery

from Section 6 - Intrapartum/Delivery

Published online by Cambridge University Press:  08 April 2025

By
Sona Jasani
Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

This case reviews the diagnosis, management, and proposed mechanisms associated with the obstetric complication of retained placenta after a vaginal delivery. Although retained placenta has been noted in the literature for almost 90 years, explanations vary. Different biological mechanisms may account for retained placenta, ranging from mechanical delay in separation to abnormal adherence. Manual removal of the placenta is common; however, alternative management depends on the clinical scenario. This case provides an overview of current practice and discusses these practice variations in the clinically stable patient.

Keywords

retained placentaundelivered placentamanual removal of placentathird stage of laborplacenta adherensplacenta accreta spectrumincarcerated placenta
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 186 - 188
Publisher: Cambridge University Press
Print publication year: 2025

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References

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American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol. 2018;132:e259–e275.Google Scholar
Nikolajsen, S, Lokkegaard, ECL, Bergholt, T. Reoccurrence of Retained Placenta at Vaginal Delivery: An Observational Study. Acta Obstet Gynecol Scand. 2013;92:421–425.Google ScholarPubMed
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National Institute for Health and Care Excellence. Intrapartum Care for Healthy Women and Babies. Clinical Guideline. CG190. www.nice.org.uk/guidance/cg190/resources/intrapartum-care-for-healthy-women-and-babies-pdf-35109866447557 (accessed June 8, 2023).Google Scholar
World Health Organization. WHO Guidelines for the Management of Postpartum Hemorrhage and Retained Placenta. https://apps.who.int/iris/handle/10665/44171 (accessed June 8, 2023).Google Scholar
Krapp, M, Baschat, AA, Hankeln, M, Gembruch, U. Gray Scale and Color Doppler Sonography in the Third Stage of Labor for Early Detection of Failed Placental Separation. Ultrasound Obstet Gynecol. 2000;15:138–142.CrossRefGoogle ScholarPubMed

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