18/04/2026
THE PLACENTA REFUSED TO COME OUT... BUT THAT WASN'T THE REAL DANGER.
She didn’t book with us.
She had her antenatal care in a maternity.
According to her, she was consistent.
She took her medications.
She did everything she was told.
When labour started, she delivered there.
A healthy baby boy.
Everything seemed fine.
Until the placenta refused to come out.
The midwife tried.
And tried again.
Different manoeuvres. Gentle traction. Everything she could.
But the placenta remained stuck.
At that point, they had no choice.
She was referred to us.
By the time she arrived, she was exhausted.
Drained.
Still carrying the placenta inside her.
The baby was fine.. crying, active.
But the mother…
She had gone through too much already. 😢
We moved fast.
Straight to the theatre.
Before we even commenced full resuscitation, I asked the midwife who came with her about the routine investigations done during pregnancy.
She brought out a paper and handed it over.
I looked through it.
Hepatitis B.. negative.
Hepatitis C.. negative.
HIV 1 & 2.. negative.
At least, that was reassuring.
Then I turned to the patient.
“Do you know your blood group?”
She hesitated.
“I don’t know my blood group… but my genotype is AA.”
At that point, we couldn’t assume anything.
We proceeded with care.
Under adequate monitoring, I performed a manual removal of placenta.
Carefully.
Systematically.
Because at that point, the biggest fear wasn’t just the retained placenta…
It was bleeding.
Thankfully, the placenta came out.
Complete.
We monitored her closely.
Admitted her.
Watched for any signs of postpartum hemorrhage.
Meanwhile, we had already sent her blood for proper investigations.
Then the results came back.
Her blood group…
O RHESUS NEGATIVE !
Immediately, something clicked.
We checked the baby.
The baby was O Rhesus positive.
That was when the real danger revealed itself.
Not the placenta.
Not even the delivery.
Something quieter.
Something invisible.
If nothing was done within 72 hours…
Her body would begin to form antibodies against Rhesus-positive blood.
And the next time she gets pregnant?
Her own body could attack her baby.
We didn’t waste time.
We immediately administered anti-D immunoglobulin (RhoGAM).
Right there.
Right on time.
And just like that…
A future tragedy was prevented.
Later, I thought about it.
What if the placenta had come out easily?
What if there was no complication?
What if she had delivered and gone home?
She might never have known.
And her next baby…
Might not have survived.
Sometimes, what looks like a complication…
Is the only reason a bigger disaster is prevented.
If you are pregnant or planning to be..
Know your blood group.
Especially your Rhesus status.
If you are RHESUS NEGATIVE, you MUST receive the necessary care after delivery.
Because it’s not just about this pregnancy…
It’s about the ones to come.
Not every danger is loud.
Some are silent.
And by the time they show up…
It may already be too late.
Please, don’t take chances.
Get proper antenatal care.
Do the right tests.
Ask the right questions.
Because sometimes…
what you don’t know
is what puts everything at risk 😊.
The Women's Doc
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