User:Mr. Ibrahem/Retained products of conception

Retained products of conception (RPOC) is when part or all of the placenta or membranes remain in the uterus in association with significant bleeding or for more than about 30 to 60 minutes following delivery of the baby. The condition may also occur after miscarriage or abortion. Symptoms may include postpartum bleeding, either at the time of delivery or later, pelvic pain, or infection.

Causes can include uterine atony, placenta accreta, or early closure of the cervix. Risk factors include multiple prior deliveries, previous surgery of the uterus, and preterm delivery. The underlying mechanism may involved failed separation of the placenta from the uterus or a separated but retained placenta. Diagnosis can be supported by symptoms or examination of the placenta for missing parts. Other measures may include ultrasound.

Treatment is generally by manual removal of the products under anesthesia or by dilation and curettage. Injecting the cord with oxytocin may be of benefit but requires further study as of 2020. Blood loss may require blood transfusions, uterine balloon tamponade, or hysterectomy. In rural areas of the developing world, it is associated with a 10% risk of death. It affects about 2% of term pregnancies; though may affect up to 40% of preterm pregnancies.