Retained products of conception (RPOC) refers to fetal or placental tissue that remains in your uterus after a pregnancy. RPOC is more common when a pregnancy ends early. RPOC can lead to bleeding, infection and other problems. Medication or minor surgery can treat RPOC.
Retained products of conception (RPOC) refers to tissue that remains in your uterus after a pregnancy ends. The tissue is usually from the placenta, which is an organ that develops in your uterus during pregnancy. However, this tissue can also be fetal tissue.
Retained placental or fetal tissue can happen after:
RPOC can cause bleeding and other health problems.
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Sometimes the entire placenta (also called “afterbirth”) remains in the uterus after childbirth. A retained placenta can lead to hemorrhaging (bleeding), severe infection or even death.
A retained placenta most commonly happens after a vaginal delivery. But RPOC is more common when a pregnancy ends early. It may not cause problems until days, weeks or even months after the pregnancy ends.
The following factors increase a woman’s risk of having RPOC:
RPOC is one of the most common reasons for postpartum (after birth) bleeding. Studies suggest it happens in up to 40% of second-trimester miscarriages or abortions. But it’s fairly rare in full-term pregnancies (a pregnancy that lasts about 40 weeks). It occurs in about 1% of these cases.
The placenta is an organ that develops as a fetus grows in your uterus. It’s attached to the wall of your uterus. It delivers oxygen and nutrients to your baby through the umbilical cord.
The placenta and other tissues that develop during pregnancy naturally deliver from the uterus during childbirth. But in some cases, some of the tissue remains in your uterus. RPOC prevent your uterus from returning to its pre-pregnancy state.
Your body goes through a lot of physical changes after pregnancy. Some bleeding and vaginal discharge are normal. But heavy bleeding or blood clots after pregnancy could indicate a problem.
Postpartum hemorrhage (vaginal bleeding after childbirth) is the most common symptom of RPOC. Other symptoms may include:
It can be difficult to diagnose RPOC based on symptoms alone. The symptoms may be similar to other postpartum health issues. The following exams and tests can confirm a diagnosis of RPOC.
Blood and tissue tests:
Imaging exams:
There are several treatments for RPOC, including:
Misoprostol doesn’t carry any significant risks (significant bleeding can occur as complication from misoprostol, but this is very rare). D&C poses a greater risk than HR of:
Perforation is rare. The uterine wall usually heals on its own. If the perforation injures other organs, you may need surgery to repair them.
Uterine scarring, or Asherman’s syndrome, is rare, but can increase your risk of:
There’s no way to prevent RPOC. But you can make sure your healthcare provider knows your full medical history. You may be at a high risk for RPOC due to past pregnancy complications or surgeries. If that’s the case, your care team will monitor your health closely during and after any future pregnancies.
Most women who receive treatment for RPOC can still get pregnant and have healthy pregnancies. In rare cases, uterine scarring may cause fertility problems.
Seek immediate medical attention if you experience any of the following symptoms after a pregnancy:
A note from Cleveland Clinic
Retained products of conception (RPOC) occur when fetal or placental tissue remains in the uterus after a pregnancy ends. Symptoms can include abnormal vaginal bleeding, fever or infection. The most common treatments for RPOC are medication or surgery. Most women don’t experience long-term complications from RPOC. But in rare cases, uterine scarring can affect fertility or future pregnancies.
Last reviewed by a Cleveland Clinic medical professional on 05/12/2021.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy