Retained Products of Conception

A small number of vaginal deliveries will be complicated by retained products of conception. This is when the placenta is not fully delivered, causing it to remain inside the uterus. Nevertheless, it is an issue that should be readily diagnosed and treated by medical professionals. If doctors fail to diagnose retained products of conception in a timely fashion, there could be grounds for a medical negligence claim.

Removing retained products of conception

After your baby has been delivered, your body should naturally expel the placenta. This is known as the third stage of delivery and sometimes medication will be injected into the thigh to speed the process up. Once the placenta has been completely removed from the uterus, medical professionals can proceed to assess a woman for perineal injuries and carry out any necessary repairs.

However, it is possible that part of the placenta and membranes remain inside the uterus. This is called 'retained products of conception' (RPOC) and is something that can also occur after a miscarriage. The issue of retained products may initially go unnoticed by medical professionals, as clinical assessment of placental completeness can be difficult. Nevertheless, the problem will soon become apparent when a woman continues to experience heavy post-partum bleeding. A patient presenting with this symptom should undergo an ultrasound scan to assess whether there is any retained placental tissue, or whether another complication is at play (such as an intra-uterine infection).

If retained products of conception are identified, an appropriate treatment plan should be devised. Although not true in every case, it is very probable that doctors will want to perform an evacuation of retained products of conception procedure (ERPC). The operation is carried out under general anaesthetic and involves gently cleaning out the uterus.

Failing to remove retained products of conception

In around 2% of cases there will still be a small amount of retained products in the uterus, even after an ERPC. This is because doctors must take extreme care during the operation – any excessive force could result in damage such as a perforated uterus. Therefore it is not always possible to remove everything in a single operation.

However, the standard of care will be questioned if doctors fail to remove retained products of conception because of a delay in diagnosis. Indeed, a woman presenting with heavy post-partum bleeding should undergo immediate investigation – namely in the form of an ultrasound scan. If this is not arranged or performed, a woman will be left to suffer prolonged pain, bleeding and possibly even infection. This will represent a substandard level of medical care, and as such the patient will be entitled to pursue legal action.

If you would like to discuss claiming compensation for medical negligence, do not hesitate to seek early legal advice.

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