Retained Placenta

Question 1

What is retained placenta? When is a placenta considered retained?

Answer 1

• retention of fetal membrane within uterus following birth
• normal expulsion occurs 3-8hrs post parturition
• considered retained after 12+ hrs

Question 2

When does retained placenta occur?

Answer 2

When the fetal membrane fails to detach from the uterus; if separation doesn’t occur, then the cotyledon isn’t passed during 3rd stage of labor

Question 3

How is a placenta normally expelled?

Answer 3

Fetal portion begins to separate from maternal uterus during last few weeks to months leading up to birth. During this time, fetal portion shrinks and starts to detach from maternal portion and strong sustained uterine contractions during 3rd stage of labor PLUS the shape changes results in expulsion of the fetal membrane.

Question 4

What is the fetal portion called?

Answer 4

fetal cotyledon

Question 5

What is the maternal portion called?

Answer 5

maternal caruncles

Question 6

What are possible risk factors for retained placenta?

Answer 6

• deficiency in vit. E, A, or selenium
• birth of male calves
• occurrence of dystocia
• longer or shorter than normal gestational periods

Question 7

Effects of retained placenta/CS that may be seen

Answer 7

• initially may only notice decreased milk production
• eventually foul odor and foul smelling discharge may develop as membrane becomes necrotic
• bacterial infection
• endotoxemia signs (depression, inappetence, pyrexia)

Question 8

List the 3 treatment options for retained placenta

Answer 8

• do nothing
• attempt manual removal thru gentle traction of protruding membrane
• systemic/intrauterine antibiotics

Question 9

What happens in the “do nothing” method?

Answer 9

-maternal caruncles will begin to slough and placenta will be slowly expelled within 4-10 days

Question 10

Is attempted manual removal thru gentle traction of protruding membrane recommended?

Answer 10

• No
• Impossible to detach fetal membrane unless enough necrosis has occurred
• Contraindicated if endotoxemia is present

Question 11

Does giving antibiotic change the course of expulsion? Does it help at all?

Answer 11

• doesn’t alter course of expulsion
• may reduce odor and bacterial population
• may reduce fertility
• indicated if endotoxemia