Undiagnosed retained placenta nineteen months post-partum presenting with massive hemorrhage- A case report

Undiagnosed retained placenta after vaginal delivery can result in significant hemorrhage, maternal morbidity, and even mortality. Several risk factors for retained placenta have been documented in the literature, including placenta accreta spectrum, previous history of uterine curettage, multiple gestations, preterm birth, velamentous insertion of placenta, poorly treated endometritis, multiparity, advanced maternal age, stillbirth, uterine anomalies, and Asherman syndrome. The occurrence of retained placenta and its associated complications, such as maternal morbidity and mortality from postpartum hemorrhage and endometritis is more common in developing countries due to a low ratio of trained obstetricians and midwives to the number of pregnant women. Different society guidelines vary on the timing of intervention in cases of retained placenta, it is therefore imperative to evaluate and tailor the management approach to each case as needed. We present a case report of a multiparous woman with an unrecognized retained placenta who presented with unprovoked torrential bleeding nineteen months after delivery.