WOMENS-HEALTH Messages for April, 1998: Re: postpartum complications

Re: postpartum complications

From: Kelly Shanahan, MD (anonymous@obgyn.net)
Thu, 30 Apr 1998 20:40:43 -0500 (CDT)

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In reply to: Beth: "postpartum complications"

At Thu, 30 Apr 1998, Beth wrote: >
>After I gave birth to my second child, I began having constant abdominal
>pain about five days later. My Dr. said it was endometritis. At 3
>weeks postpartum I began bleeding heavily and they did an ultrasound and
>found retained placenta. I had a D&C and had bleeding and discharge
>after that for more than 4 weeks. The size of placental parts removed
>was quite large and the Dr. said it may have been placenta accretia in
>a report but nothing was said to me directly and my question about it
>wasn't answered directly. My questions are can this cause problems with
>future pregancies? Could this have been prevented or even found earlier?
>And how common is retained placenta? I have searched for answers, and I
>am having difficulty finding much info on it. Thanks.
>

Placenta accreta means the placenta is abnormally adherent to the uterine wall; the palcenta does not separate normally after the baby is born, and all or part of it may not come out. If you have had a placenta accreta in the past, you are more likely to have it occur again in hte future.

Sometimes, very careful ultrasound scanning can detect an abnormal interface between the placenta and the uterine wall -- it would need to be looked for specifically and probably would be best done in a higher level ob center, by an experienced perinatologist or ob ultrasonographer.If we know htere is a placneta accreta, we can be prepared at the time of delivery -- maybe by doing a D&C right there to try to remove nay adherent fragments. Placenta accreta (and increata nd percreata, which are even worse) can be a very serious complication to mom, involving significant blood loss. Be sure to ask you doctor specifically if you had a placneta accreata this time (soemtimes the placneta is not abnormally adherent at all, but a small lobe, or piece, just doesnt';t come out with the rest).

--
Kelly Shanahan, MD, FACOG
S. Lake Tahoe, CA

note: Opinions here are for educational purposes only. This information is not intended to supplant the need for you to consult with your own physician. It cannot take the place of a face to face consultation and examination.
Sorry, but private e-mails will not be answered.

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