O72.2

Clinical Causes: Retention of placental parts or membranes after delivery, which can prevent proper uterine contraction and lead to bleeding. Incomplete expulsion of products of conception, including placental tissue or membranes. Uterine atony or failure to involute properly, which can result in bleeding. Infections causing tissue breakdown or delayed shedding of the placental tissue. Other obstetric complications that impede complete uterine contraction or healing.

Key Symptoms: Vaginal bleeding that occurs several days to weeks after delivery. Passing of tissue or clots with the bleeding. Uterine tenderness or fullness. Lower abdominal or pelvic pain. Signs of anemia, such as fatigue or dizziness in severe cases. Fever, if infection is present.

Diagnosis Path: Healthcare providers diagnose delayed or secondary postpartum hemorrhage through a combination of patient history, physical examination, and diagnostic tests. Ultrasound imaging is often used to identify retained placental tissue or membranes. Laboratory tests may assess hemoglobin levels to evaluate blood loss and detect anemia. The identification of retained products of conception confirms the diagnosis, guiding appropriate management.

Treatment Protocols: Treatment options focus on removing the retained tissue and controlling bleeding. Common approaches include: - **Manual removal:** Conducted by a qualified healthcare professional to evacuate retained tissue. - **Medications:** Such as uterotonics to promote uterine contractions and reduce bleeding. - **Surgical procedures:** Like dilation and curettage (D&C) if manual removal is insufficient. - **Antibiotics:** If an infection is diagnosed or suspected. - **Supportive care:** Including blood transfusions in cases of significant blood loss. Prompt medical intervention helps prevent complications like severe anemia or infections, contributing to a safer recovery for the mother.