Can retained placenta cause postpartum haemorrhage?

The placenta may remain wholly or partly inside the uterus after the baby is born. Bleeding can begin soon after delivery or develop later when a small piece of placental tissue remains.

Once the placenta separates, the uterine muscle should tighten around the open blood vessels at its attachment site. Retained tissue can interfere with this contraction, leaving vessels less compressed. The retained placenta itself may also remain attached and continue to bleed.

Postpartum haemorrhage has other causes as well, including poor uterine contraction without retained tissue, a birth-canal tear or a clotting problem. The maternity team checks these possibilities while controlling blood loss.

Staff assess bleeding, uterine firmness, the delivered placenta, pulse and blood pressure. Immediate care may include medicines to contract the uterus, intravenous fluids and removal of retained placental tissue. Blood support, antibiotics or a procedure in an operating theatre may be needed according to the clinical situation.

If you are recovering at home, monitor whether bleeding is becoming heavier rather than lighter and tell a clinician about fever, worsening lower abdominal pain, unpleasant-smelling discharge or persistent clots. Do not try to remove visible tissue yourself.

Tell maternity staff at once about sudden or heavy bleeding. After leaving hospital, call emergency services if bleeding soaks pads rapidly or occurs with large clots, dizziness, fainting, breathlessness, confusion, severe weakness, a racing heartbeat or pale, cold and clammy skin.

Postpartum haemorrhage can worsen quickly. Have someone remain with you, lie down if you feel faint, and avoid driving while urgent help is on its way.

Ask whether the placenta appeared complete, what caused the bleeding, which treatment was given and whether your blood count needs follow-up. Before another birth, share this history and ask how the planned place of delivery and preparation may change.