Here's what you need to know about a retained placenta
In a recent episode of Keeping Up with the Kardashians, Kim Kardashian was told by doctors that a third pregnancy could be life-threatening for her due to the possibility of a condition known as a retained placenta. Kardashian had placenta problems during her first pregnancy (with daughter North, 3) and after delivery, she had surgery to remove a piece of placenta from her uterus.
1. What is a retained placenta?
In most labors, the placenta — the organ responsible for providing the baby with oxygen and nutrients in utero — is expelled by the woman's body within 30 minutes of delivery. In some cases, the placenta (or a part of it) remains in the womb for more than 30 minutes after delivery. According to the World Health Organization guide, "Managing complications in pregnancy and childbirth," this is known as a retained placenta. In developed countries, it affects around 3 percent of vaginal deliveries.
2. Are all retained placentas the same?
No. The most common of the three types is placenta adherens. This happens when the uterus doesn't contract enough to expel the placenta, and it remains attached to the uterine wall. The other types of retained placenta are trapped placenta and placenta accreta. Trapped placenta happens when the placenta does detach from the uterus, but remains in the body. Typically, this is due to the cervix beginning to close before the removal of the placenta. Placenta accreta happens when the placenta attached to the muscular layer of the uterine wall instead of the uterine lining, which leads to severe bleeding and can make delivery very difficult. Blood transfusions or a hysterectomy may be required if bleeding cannot be stopped.
3. What are the risks of a retained placenta?
If untreated, a retained placenta can lead to a severe infection and excessive blood loss, which can be life-threatening for the mother.
4. Are certain women more at risk of a retained placenta?
Women over the age of 35, women who go into labor before the 34th week of pregnancy, women who have a prolonged first or second stage of labor (the expulsion of the placenta is considered the third stage of labor), and women who are having a stillborn baby are at a greater risk of a retained placenta. And if you've had a placenta problem during a previous pregnancy, you may be at increased risk of it happening again.
5. How can a retained placenta be treated?
It's crucial to remove the entire placenta from the uterus, which may be done by a doctor by hand or using medication to either relax or contract the uterus. Breastfeeding may also be effective, as it releases the hormone oxytocin in the body, which makes the uterus contract. A last resort is surgery to remove the placenta or any missing parts of it.
6. Can a retained placenta be prevented?
If a woman is at risk of a retained placenta, there are several steps her doctor can take to reduce that risk. Medication to make the uterus contract and release the placenta, such as Pitocin (oxytocin), can be prescribed. Controlled cord traction can be applied by the doctor, which involves clamping the baby's umbilical cord then pulling on the cord while applying pressure to encourage the placenta to come out after the baby is born. Additionally, the doctor can use their hands to stabilize the uterus, while applying controlled cord traction.
Ultimately, a retained placenta is a rare complication. But as with all aspects of pregnancy, knowledge is the key to remaining in control and making the best decisions for you and your baby.