Placenta, retained

Failure of the placenta (afterbirth) to be ejected within an hour of the birth of the baby. After the birth of the baby the placenta detaches itself from the wall of the contracting uterus, but may not always be expelled immediately. If little blood is being lost, there is no harm in waiting, but after an hour the chance of serious post-natal haemorrhage is increased. Then usually attempts are made to expel the afterbirth by abdominal manipulation; this is also necessary if severe haemorrhage sets in immediately after the birth. If the placenta, or part of it, is still retained after manipulation, it is removed under general anaesthetic.