Sometimes the placenta can not exfoliate from the uterine wall completely, and some parts of it remain in the uterine cavity. This pathology is called - a placental defect .
Diagnose this pathology when examining the maternal surface of the placenta due to the absence of one or more particles and the bleeding of tissues at the site of the defect. In the uterine cavity, an additional part may remain, which is located on the fertile membranes. Recognize the presence of such a part can be traced the course of the vessels of the fertile surface of the placenta. Vessels go beyond the placenta and suddenly break off on the shells.
When the proportion of the placenta remains in the uterine cavity, it contributes to the disruption of the contractile activity of the uterus, which is fraught with hypotonic bleeding, infection (postpartum endometritis).
If there is a defect in the placenta or when there is an additional part in the uterus or 2/3 of the membranes or even if there is a suspicion of a delay in the placenta in the uterus, it is necessary to perform an operation - a manual examination of the uterine cavity and removal of the placenta.
Sometimes the placenta, which has separated from the walls of the uterus, can not be born at the strain of the mother in childbirth, due to the pinching of the afterbirth in the uterine cavity. This happens with the introduction of large doses of uterotonic drugs, rough massage of the uterus and the vices of its development. If the bleeding is infringed, bleeding is or may be absent, signs of placental separation are positive. In these cases, the introduction of antispasmodics, the isolation after the administration of Krede-Lazarevich, and the ineffectiveness of conservative measures, highlight the litter in a manual examination of the uterine cavity under general deep anesthesia.