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Background: Abnormal placentation and retention of products of conception (RPOC) are common causes of postpartum hemorrhage. Case: A 37-year-old gravida 4 para 1 woman with history of Asherman’s syndrome from prior dilatation and curettage presented in spontaneous labor. Following normal vaginal delivery, portions of the placenta were retained and had to be manually extracted. Two weeks following delivery, she returned to the hospital with persistent vaginal bleeding. Ultrasound and magnetic resonance imaging demonstrated an endometrial mass with vascularity. During her hospital evaluation, she continued to bleed and ultimately underwent a total abdominal hysterectomy. Results: Gross and histologic evaluation of the uterus demonstrated retained placenta accreta.

Retained Placenta Accreta Presenting as Secondary Postpartum Hemorrhage