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Case Report
The forgotten fragment: Unmasking a rare case of calcified retained placenta at 20 weeks postpartum
1 Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA
2 Inova Fair Oaks Hospital, Fairfax, Virginia, USA; Tepeyac OB/GYN, Fairfax, Virginia, USA
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Yasaman Dasteh Goli
Edward Via College of Osteopathic Medicine, Blacksburg, Virginia,
USA
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Article ID: 100040G06YG2025
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Dasteh Goli Y, Cvetkovich LL. The forgotten fragment: Unmasking a rare case of calcified retained placenta at 20 weeks postpartum. Edorium J Gynecol Obstet 2025;9(1):1–5.ABSTRACT
Introduction: Retained products of conception (RPOC) are a recognized cause of secondary postpartum hemorrhage, most commonly occurring within the early postpartum period. However, delayed presentations with calcified RPOC are rare and pose unique diagnostic challenges. While advanced maternal age, uterine atony, prior cesarean sections, and abnormal placentation— such as placenta accreta spectrum and succenturiate placenta—are common risk factors, RPOC can also occur in low-risk patients and require careful clinical management.
Case Report: A 25-year-old G1P1 woman with an uncomplicated pregnancy and vaginal delivery presented with persistent intermittent bleeding 20 weeks postpartum. Despite undetectable serum hCG levels and no signs of infection, serial ultrasounds revealed a calcified mass at the uterine fundus. The patient underwent hysteroscopy with dilation and curettage (D&C), confirming the presence of calcified placental fragments with fibrosis. Her symptoms resolved postoperatively, and no complications were observed. The findings suggest a likely retained succenturiate lobe, an uncommon placental abnormality that was undetected in the immediate postpartum period.
Conclusion: This case highlights the importance of clinical vigilance and timely intervention in managing postpartum complications, particularly in an evolving obstetric population where advanced maternal age and the use of assisted reproductive technologies are becoming more prevalent. Early identification of RPOC, aided by imaging modalities such as ultrasound and saline infusion sonohysterography, and prompt treatment with hysteroscopy and D&C are essential to prevent complications such as chronic endometritis and intrauterine adhesions. Recognizing rare placental anomalies is critical for optimizing patient outcomes.
Keywords: Calcified placental tissue, Delayed postpartum bleeding, Postpartum bleeding, Retained products of conception (RPOC), Succenturiate placenta
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Author Contributions
Yasaman Dasteh Goli - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Lorna L Cvetkovich - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Yasaman Dasteh Goli et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
