Retained placental fragments6/6/2023 ![]() No clinical significance unless extensive, in which case there may be placental insufficiency with intrauterine growth retardation or other poor fetal outcomeĬlot, especially an adherent clot toward the center of the placenta, with distortion of placental shapeįresh clot located along the margin, with no distortion of placental shape Increased incidence of postpartum infection and hemorrhageĪbnormalities of the maternal placental surface and substance Probable retained placenta, with surgical removal required Multiple lobes (bilobate, bipartite, succenturiate, accessory) Placenta membranacea (rare condition in which the placenta is abnormally thin and spread out over a large area of the uterine wall associated with bleeding and poor fetal outcome) Possible placental insufficiency with intrauterine growth retardation Retained tissue is associated with postpartum hemorrhage and infection Probable retained placental tissue (e.g., in cases of retained succenturiate lobe of placenta) Velamentous vessels present (see Figure 6) Probable retained placental tissue (e.g., in cases of placenta accreta) No velamentous vessels vessels taper to periphery of placenta The placenta should be submitted for pathologic evaluation if an abnormality is detected or certain indications are present. Numerous common and uncommon findings of the placenta, umbilical cord and membranes are associated with abnormal fetal development and perinatal morbidity. ![]() Tissue may be retained because of abnormal lobation of the placenta or because of placenta accreta, placenta increta or placenta percreta. The color, luster and odor of the fetal membranes should be evaluated, and the membranes should be examined for the presence of large (velamentous) vessels. The umbilical cord should be assessed for length, insertion, number of vessels, thromboses, knots and the presence of Wharton's jelly. During the examination, the size, shape, consistency and completeness of the placenta should be determined, and the presence of accessory lobes, placental infarcts, hemorrhage, tumors and nodules should be noted. The findings of this assessment should be documented in the delivery records. A one-minute examination of the placenta performed in the delivery room provides information that may be important to the care of both mother and infant.
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