Role of Ultrasound in the Diagnosis of Retained Placenta

Abstract

A 30-year-old female, in her second pregnancy at approximately 37 weeks of gestational age, presented with excessive pervaginal bleeding for four hours following a home delivery. A previous single antenatal ultrasound was performed at 13 weeks of gestational age, which indicated that the placenta was developing along the posterior uterine wall. During the current ultrasound examination, the uterus was found to be enlarged and bulky. A large hyperechoic structure measuring approximately 11.2×7.6×6 cm was observed in the fundo-posterior wall of the uterus [Table/Fig-1], showing minimal vascularity on colour Doppler [Table/Fig-2]. This was identified as the non expelled retained placenta. Due to the diagnosis of retained placenta and the possibility of atonic Postpartum Haemorrhage (PPH), a hysterectomy was performed by the obstetrician under anaesthesia to prevent further uncontrolled blood loss. The uterus, along with the retained placental tissue, was removed [Table/Fig-3a,b]. Following the surgery, the patient experienced a cessation of blood loss, and her vital signs remained stable.

Keywords

• hysterectomy
• myometrium
• postpartum haemorrhage