Births are divided into three periods: the opening of the cervix, an excruciating, during which the fetus is ejected, and a succession. Separation and exit of the placenta is the third stage of labor, which is the least prolonged, but no less responsible than the two previous ones. In this article, we will look at the features of the post-holistic period (how it is led), the definition of signs of separation of the placenta, the reasons for incomplete separation of the placenta, and methods for separating the afterbirth and its parts.
Signs of the placenta
After the birth of a child, a child 's place should be born. It is important to note that in no case should you pull the umbilical cord to accelerate this process. A good preventive measure of detainment is the child's previous application to the breast. Breast sucking stimulates the production of oxytocin, which contributes to the reduction of the uterus and the separation of the placenta. Intravenous or intramuscular administration of small doses of oxytocin also accelerates the separation of the placenta. To understand whether separation occurred afterwards or not, you can use the described signs of the placenta:
- Schroeder's sign: after separation of the placenta, the uterus rises above the navel, becomes narrow and deviates to the right;
- a sign of Alfeld: the exfoliated placenta descends to the inner throat of the cervix or vagina, while the outer part of the umbilical cord lengthens by 10-12 cm;
- when the placenta is separated, the uterus contracts and forms a protrusion over the pubic bone;
- a sign of Mikulich: after separation of the placenta and its lowering in the parturient woman, there is a need to strain;
- Klein's testimony: when stretching a woman in labor, the umbilical cord lengthens. If the placenta has separated, then after an exertion the umbilical cord is not pulled;
- a sign of Kyustner-Chukalov: when pressing the obstetrician over the pubic symphysis with the separated placenta, the umbilical cord will not be drawn.
If the childbirths proceed normally, the latter will separate not later than 30 minutes after the fetal expulsion.
Methods for isolating the separated afterburn
If the separated placenta is not born, then special techniques are used to accelerate its release. First, increase the rate of administration of oxytocin and organize the release of the after the external methods. After emptying the bladder, the mother is offered to labor, while in most cases the placenta leaves after delivery. If this does not help, apply the Abuladze method, in which the uterus is gently massaged, stimulating its contractions. After that, the maternity's belly is taken with both hands in a longitudinal crease and offered to strain, after which the latter should be born.
Manual isolation and detachment
Manual removal of the placenta is carried out with ineffectiveness of external methods or with suspicion of placental remains in the uterus after childbirth. Indications for manual separation of the placenta is bleeding in the third stage of labor in the absence of signs of separation of the placenta. The second indication is the absence of placenta separation for more than 30 minutes with ineffectiveness of external methods of separation of the placenta.
Technique for manual removal of the placenta
With the left hand, the ancestral ways are moved apart, and the right one is inserted into the uterus cavity, and, starting from the left rib of the uterus, the placenta is separated with sawing movements. The obstetrician should hold the bottom of the uterus with his left hand. Manual examination of the uterine cavity is also carried out with a separated afterbirth with identified defects, with bleeding in the third stage of labor.
After reading it is obvious that, despite the short period of the third period of labor, the doctor should not relax. It is very important to carefully examine the isolated afterburn and make sure of its integrity. If after birth, parts of the placenta remain in the uterus, this can lead to bleeding and inflammatory complications in the postpartum period.