Retained placental fragments anyone? - Mothering Forums
Birth and Beyond > Retained placental fragments anyone?
mochimama's Avatar mochimama 12:51 AM 10-24-2006
Has anyone out there had retained placental fragments?
What was it like when they finally came out?
How long did it take after birth?
Did it affect your milk supply?

I had a low milk supply after birth of dd and had no idea why. About 8 weeks postpartum (I was still bleeding slightly at this point), I had a huge gushing bleed, soaking my pants, all over the floor, running down my legs, with more after I sat on the toilet. I didn't examine them long, but I saw small pieces of tissue in the toilet after I sat there. Only later did I read that retained placental fragments can lead to low milk supply as the hormone that causes the milk to come in is triggered by the placental delivery.
When I told dd's ped about the bleed (she delivered dd), she told me I probably was just getting my period and it came out all at once : Never heard of that before and it's got to be totally wrong since I haven't had a period since and it's been four months.
My ob/gyn told me it was probably retained placental fragments which makes more sense and what I suspected myself.
I'm just trying to figure out if this is what caused my low milk supply in the beginning. I am exclusively bfing now, but hardly had any milk in the beginning. I never got engorged or felt any breast heaviness at all the first weeks pp and when I went to a lactation consultant at 3 weeks pp, a before and after feeding weight on dd indicated that she only got one fifth of an ounce after feeding from both sides
I'm just looking for an explanation and am wondering if anyone else experienced something similar.

mwherbs's Avatar mwherbs 04:46 AM 10-24-2006
8 weeks is a long time but possible- what I am wondering though is if the part retained was accreted. I have read reports of conservative management of placenta accreta and they leave it alone and wait--
the longest I have had women with placenta fragments has been 2 weeks- it would all just depend on how long it took for your tissues to fill in and repair around it enough to reject/push out the parts that didn't belong-- I guess
Llyra's Avatar Llyra 06:48 AM 10-24-2006
I had retained tissue after DS's birth. It took about six days before I passed it. I had a lot of dull cramping for days, that built up into really intense cramping, and then I had the urge to push and the tissue came out.

I don't know how the retained tissue affected my milk, since DS didn't survive his birth (he was extremely premature.) But it sounds very very logical to me that retained tissue would have an effect on establishing milk supply.
Sonnenwende's Avatar Sonnenwende 07:14 AM 10-24-2006
I had something similar happen to me. It took around 3.5 weeks to properly diagnose and remove (all rotting and infected by this time) because I had other complications after the birth. My milk didn't come in until day 6-7 and then no matter what, I could never get more than an ounce out of both breasts. I was never engorged, my breasts never ever felt even half full. I became too sick to bother with it and we eventually switched to formula completely.

It took me three months after the birth to get my period back.
mommy_e's Avatar mommy_e 10:02 AM 10-24-2006
After my first baby I had something similar. It was around 6.5-7 weeks, I remember because it was after my PP check. It was on a weekend, and there wasn't much bleeding with it, so I never followed up because by Monday it was done. I had even called the OB at 4 wks saying my PP flow is not any less than it was 4 days after delivery and they said to just wait. It slowed down to spotting by the 6wk check, so I forgot to mention it. Then 4-5 days later I had a bit more bleeding and a hunk of tissue come out in the toilet (sorry if TMI). The spottting lasted about 2 more days and then nothing else.

I believe now that it was retained placenta. I had low supply with DS1 and had to pump and give bottles for about 6 weeks so he would gain weight. After that my supply went up. When I had DS2, he had the same latching problems that DS1 did (needed occupational therapy to learn), but never had weight gain problems, just trashed my nipples. I think the difference was an unhindered milk supply.
because's Avatar because 10:40 AM 10-24-2006
While I've heard of retained placenta stories that aren't so bad, mine is kinda icky. I retained some after DS's birth and lost ALOT of blood; went by ambulance to the hospital; three attempts at manual extraction; finally a D&C under emergency general anesthetic; 2 blood transfusions; hemocrit in the 5s (started at 12); lots of lochia for weeks; and a long recovery. My midwife said it was accretia--but she hadn't seen the surgical records so I'm not sure how she knows. I never got engorged like after DD's birth but I'm tandem nursing so I think DD helped with that. DS gained well so I think that I didn't have any low supply issues. But in my case, the placenta was out within 6 hours of the birth, not days or weeks.

I'm wondering if some of the mild retained placenta stories could be a clot? After DD's birth, I would have days of very little or no blood, followed by a chunk and heavier bleeding. No odor or fever, etc. I'm fairly sure that most placentas retained for a long time will be rejected and get pretty gross (like Sonnenwende's story). I'm not a doc/midwife, though.

Hope you're feeling well now!
mochimama's Avatar mochimama 03:51 AM 10-25-2006
for your replies Mamas! It sounds like if it was placental fragments, they would have been pretty yucky after 8 weeks. And it was just a big gusher, non yucky bleed. So I'm thinking it could be placental accretion. Is that where a piece of the placenta stays attached to the uterine wall and then continues to grow? I couldn't find a definition on the internet anywhere, so that's what I'm guessing it means. That sounds more feasible with my symptoms.
I'm sorry that many of you had a bad time of it. Thanks for your input I'm trying to get this resolved in my brain so I can move on...
mwherbs's Avatar mwherbs 12:35 PM 10-25-2006
an acreta would be where the placenta or part of the placenta implanted deeper into mom's tissues-beyond the endometrial layer. the placenta is baby tissue and not really part of mom's body it adheres something like the way velcro adheres where the parts entangle but don't mix- the baby's body is responsible for the growth and circulation within the placenta- so when the baby is not in the uterus any more the source of growth is removed but if the placenta is adherent it takes time for it to disentangle - and that time period is variable
mochimama's Avatar mochimama 03:31 PM 10-25-2006
mwherbs for sharing your knowledge
OnTheFence's Avatar OnTheFence 11:42 PM 10-25-2006
Originally Posted by mochimama View Post
Has anyone out there had retained placental fragments?
What was it like when they finally came out?
How long did it take after birth?
Did it affect your milk supply?
I haven't but I had a friend who did and my SIL.

My friend ended up having two D&Cs. She also got an infection and had to be on antibiotics for weeks. She had the first D&C about 2 weeks after the birth, and then another a few weeks later. She only breastfed for six weeks but it did not seem to affect her milk supply.

My SIL is another story. Twn days post partum she passed out after bleeding pretty badly for two days at home. She was having milk supply issues at the time. She was rushed to the hospital, had an emergency d&C and another proceedure (unsure what it was). She lost so much blood that she required 8 units of blood over the course of two days. She also had an infection. She never breastfed her baby again because after the seperation he refused the breast. However she did pump for 12 weeks. It took her about a week to get full milk supply AFTER she got home from the hospital.
kungfumoose's Avatar kungfumoose 04:17 PM 10-26-2006
It's funny you should mention this.

I had a piece of placenta come out at 2.5 weeks PP. I am actually pretty mad, because I had an emergency c-section. I would have thougth they could have gotten it all!!

I wasn't engorged when my milk came in, and I had a horrible time nursing. My daughter would suck like a little baracuda, and I ended up with bleeding nipples. It turns out she was just getting as much milk as she could.

I had lots of bleeding, and lots of clots, then it came out, it was the size of my palm. 6 hours later I got engorged, and now I struggle with oversupply (which runs in my family)
I called the OB, but he kept saying ti was just a clot, and told me not to come in. I know it was placenta, because it was tissue, not a clot.

It's been 5 weeks since the placenta piece came out.
I have been having a lot of dizziness and low belly cramps, and it smells funny (sorry TMI) i'm going into the doctor tommorow.

Watch yourself, if it was placenta, you could still have a mild infection. (I think that it what's happening to me)

Good luck.

goddessgold1's Avatar goddessgold1 10:34 PM 10-28-2006
With my 2nd birth, part of the placenta had stayed inside, my midwife reached in and "scraped" I passed out for 3 hours. I didnt even get to hold the baby, my dh did the whole time. I didnt notice that it affected my breastfeeding at all, but the after cramps where the worse I had ever had.
3daughters's Avatar 3daughters 11:11 PM 10-29-2006
I had retained placenta after the births of my first two daughters. I suspect it was a side effect of the epidurals since it didn't happen with my third dd's unmedicated birth. BTW, after both births, my uterus was manually cleaned out by the OB since the placenta didn't appear to be complete.

After dd1, I had a funny odor a few days pp. I spiked a fever and called my OB. She made me an emergency appt and did an ultrasound. She reveiled retained placenta. I was prescribed oral antibiotics and methergin and sent home. I had no problems with milk supply and did get engorged at 3 days pp.

After dd2, I spotted for about 10 weeks pp. Frustrated, I dragged myself into the OBs office. An ultrasound reveiled tissue in my uterus. A week later I had a hysteroscopy in the clinic and the OB decided to a D&C while he was in there (unmedicated!). The pathology showed that it was, indeed, retained placenta and I stopped bleeding completely 4 days later. Again, I had no problems with milk supply, dd was so plump! However, I did have a terrible time with sore nipples that wouldn't heal and we wonder whether my body wasn't functioning optimally because of the retained placenta.