Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics
The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous tre...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Journal of Pregnancy |
| Online Access: | http://dx.doi.org/10.1155/2014/274651 |
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| author | Fiona Urner Roland Zimmermann Alexander Krafft |
| author_facet | Fiona Urner Roland Zimmermann Alexander Krafft |
| author_sort | Fiona Urner |
| collection | DOAJ |
| description | The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of
PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity. |
| format | Article |
| id | doaj-art-31c19b03dd494f25a782e462d10166a3 |
| institution | Kabale University |
| issn | 2090-2727 2090-2735 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Pregnancy |
| spelling | doaj-art-31c19b03dd494f25a782e462d10166a32025-02-03T00:59:07ZengWileyJournal of Pregnancy2090-27272090-27352014-01-01201410.1155/2014/274651274651Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in ObstetricsFiona Urner0Roland Zimmermann1Alexander Krafft2Division of Obstetrics, Department of Obstetrics and Gynecology, University Hospital Zurich, 8091 Zurich, SwitzerlandDivision of Obstetrics, Department of Obstetrics and Gynecology, University Hospital Zurich, 8091 Zurich, SwitzerlandDivision of Obstetrics, Department of Obstetrics and Gynecology, University Hospital Zurich, 8091 Zurich, SwitzerlandThe third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity.http://dx.doi.org/10.1155/2014/274651 |
| spellingShingle | Fiona Urner Roland Zimmermann Alexander Krafft Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics Journal of Pregnancy |
| title | Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics |
| title_full | Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics |
| title_fullStr | Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics |
| title_full_unstemmed | Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics |
| title_short | Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics |
| title_sort | manual removal of the placenta after vaginal delivery an unsolved problem in obstetrics |
| url | http://dx.doi.org/10.1155/2014/274651 |
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