What Are The Retained Products Of Conception?
The term retained products of conception (RPOC) refers to placental and/or foetal tissue that remains in the uterus after a regular delivery, miscarriage, or abortion. Retained products of conception are thought to complicate around 1% of all pregnancies in the UK – roughly 72,000 per year.
What Causes Products of Conception to Be Retained?
There are three main causes of a retained placenta after birth, abortion, or miscarriage. These are:
- Uterine atony – a condition where the uterus either stops contracting, or doesn’t contract enough for the placenta to separate from the wall of the uterus.
- Adherent placenta – a condition when all or part of the placenta is stuck to (or in rare cases, embedded in) the uterine wall, and therefore cannot separate.
- Trapped placenta – a condition when the placenta comes away from the uterus, but then becomes trapped behind a semi-closed cervix.
Sometimes, a part of the placenta may stick to a scar from a previous caesarean section. This is a serious condition called a placenta accrete, and it is imperative that doctors are able to quickly diagnose it and recommend treatment. This should be picked up during pregnancy, which will mean plans can be made to have the baby in an obstetric unit, where the right level of care can be provided.
What Are The Symptoms Of Retained Products Of Conception?
The symptoms of a retained placenta tend to strongly resemble other gynaecological conditions, but midwives should be of sufficient experience and expertise to diagnose the condition during a routine post-natal exam, which should test for these kinds of complications. After the placenta is delivered, the uterus typically contracts down to close off all the blood vessels inside the uterus. If the placenta only partially separates, as is often the case when it is retained, the uterus can’t contract properly, allowing blood vessels inside to continue to bleed.
If the managed delivery of the placenta takes longer than 30 minutes after birth or miscarriage, the risk of heavy bleeding increases. Heavy bleeding in the first 24 hours after birth is known as primary postpartum haemorrhage (PPH).
If fragments of placenta or membrane are retained, and the midwife or doctor miss this, heavy bleeding and infection may later be caused, known as secondary PPH. Where this occurs, a claim for medical negligence may sometimes be built.
How Should A Retained Placenta Be Treated?
Where retained products of conceptions are identified, a doctor may need to remove the placenta by hand. Prior to this happening, a thorough explanation of the risks inherent with the operation should be provided, detailing the risks of pain, internal damage, and infection. A full bladder may prevent the retained placenta from being expelled from the uterus, and so where necessary the midwife should insert a catheter to drain the bladder prior to operation. An anaesthetist will then provide either a general anaesthetic (spinal or epidural) or local anaesthetic to numb the area and prevent pain.
The patient’s legs should then be lifted into stirrups (known as the lithotomy position) in the operating theatre whilst under the anaesthetic, and the doctor will remove the placenta and any remaining membranes from the uterus by hand. Intravenous antibiotics should be administered to prevent infection, and more may be prescribed to help the uterus to contract down.
If prolonged heavy-bleeding is still experienced within the days or weeks following the operation, a doctor should refer the patient for an ultrasound scan to check for any fragments of placenta or membrane in the uterus.
Where negligence fails to warn of potential risks, causes complications to worsen or develop, or delays in diagnosis means prolonged discomfort before the necessary procedure is performed, a medical negligence claim for compensation may be built.
Our Retained Products of Conception Claims Experience
Errors arising from cases of retained products of conception negligence or misdiagnosis may hold dire repercussions for patients. At Asons, we understand what clinical negligence is, and the detrimental effect it has on victims. The consequences may not just be physical – potential financial difficulties must also be considered, and the ensuing stress could elicit negative psychological consequences.
We know that victims are often hesitant to come forward with their claims. As medical negligence solicitors, it’s our job to do everything within our means to make the process as straightforward as possible.
As with any claim, you may be worried about the potential costs of pursuing your clinical negligence case. To address this common concern, we have devised a variety of options to help you. We help acquire all the assistance that you are entitled to, whilst managing resulting compensation in the most beneficial way possible. We must remind you to be quick, however, as there are time limits in place for making claims of this kind.
We deal with medical negligence claims on a regular basis. If you are suffering as a result of substandard treatment, you may be eligible to make a claim. Our Medical Negligence Solicitors will work to collate all of the appropriate paperwork and documentation, whilst speaking to the parties involved, substantiating your medical claim.