Final answer:
A retained placenta, which can lead to postpartum hemorrhage, is linked to several risk factors such as placenta previa, placental insufficiency, and structural abnormalities related to PPROM. Proper management is crucial to prevent PPH, including manual or surgical removal if spontaneous delivery of the placenta fails.
Step-by-step explanation:
When discussing the risk factors or history associated with retained placenta causing postpartum hemorrhage (PPH), it's important to consider various factors that might contribute to this condition. A retained placenta occurs when part or all of the placenta remains in the uterus during the postpartum period. This can hinder uterine contractions, which are essential for both reducing blood loss from the placental site and aiding in the process of involution - the return of the uterus to its pre-pregnancy size.
Conditions like placenta previa, where the placenta partially or completely covers the cervix, can complicate the delivery of the placenta. Additionally, factors such as placental insufficiency, which leads to inadequate transfer of oxygen and nutrients to the fetus, may also contribute to a retained placenta. The presence of a bacterial infection or structural defects in the amniotic sac, uterus, or cervix, as seen in cases of preterm premature rupture of membranes (PPROM), can also increase the risk.
The management of a retained placenta involves manual removal by the obstetrician, and if unsuccessful, surgery may be required to prevent PPH. It's vital for the healthcare provider to ensure the complete delivery of the placenta and membranes after birth to avoid complications.