Which term describes the placenta not expelled within 30 minutes after birth?

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

Answer: (D)

After birth, the placenta is normally delivered within a few minutes to about 30 minutes. If it remains inside the uterus and is not expelled within 30 minutes, this condition is called a retained placenta. It matters because the placental site can continue to bleed and the uterus may not contract well around retained tissue, raising the risk of postpartum hemorrhage. Retained placenta can occur with problems of placental adherence (such as placenta accreta, increta, or percreta) or simply due to inadequate uterine contractions.

Management aims to ensure complete delivery and control bleeding: assess uterine tone and whether the placenta has separated, administer uterotonic medications to encourage contractions, and proceed with manual removal if it does not deliver spontaneously, usually under appropriate anesthesia with measures to prevent infection and manage blood loss. This is different from placental abruption (detachment before birth causing painful bleeding), placenta previa (placenta over the cervical opening), or uterine inversion (the uterus turning inside out after delivery).