A placenta that has not undergone placental expulsion within 30 minutes of the baby's birth and can cause postpartum hemorrhage

• A. Placenta previa
• B. Placental abruption
• C. Placental accreta
• D. Retained placenta

Answer: (B)

This question tests recognizing a retained placenta as a cause of postpartum hemorrhage. When the placenta does not deliver within about 30 minutes after birth, it’s considered retained. This situation can lead to heavy bleeding because the placental site continues to bleed and the uterus may not contract effectively to stop the flow.

Placenta previa involves implantation low in the uterus and typically presents with painless bleeding before birth, not a failure to expel after delivery. Placental abruption is the premature separation of the placenta before birth, usually with painful bleeding and fetal distress. Placental accreta is abnormal adherence of the placenta to the uterine wall, which can make separation difficult and cause hemorrhage, but the specific descriptor for failure to expel after birth is retained placenta.