RPOC stands for retained products of conception. This is where all or part of the placenta or membranes are left in the uterus during the final stage of labour. In most cases this is detected following the examination of the placenta after delivery.
Retained placenta can be caused by:
- failed separation due to failure of uterine contraction or morbid adherence e.g. to a fibroid or scar
- separated but retained due to e.g. a snapped cord contracted uterus, closed cervix
Reports suggest that retained placenta is one of the mosts common causes of postpartum haemorrhage.
There are a number of options for treating RPOC here is the most commonly used
Women with a retained placenta oxytocin injection into the umbilical vein with 20 IU of oxytocin in 20 ml of saline is recommended, followed by proximal clamping of the cord. If the placenta is still retained 30 minutes after oxytocin injection, or sooner if there is concern about the woman’s condition, women should be offered an assessment of the need to remove the placenta. Women should be informed that this assessment can be painful and they should be advised to have analgesia or even anaesthesia for this assessment
It is worth pointing out that this is very rare and that it very rarely causes any problems however in few cases a hysterectomy may be needed as a PPH occurs or a severe infection.