Lectures

Labor Stage 3: Placenta Delivery

by Veronica Gillispie, MD, FACOG
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    00:01 Now let's discuss the third stage of labor.

    00:05 So let's review our stages of labor.

    00:07 Stage 1 is the onset of labor until 10 centimeters dilated.

    00:11 Stage 2 is 10 centimeters dilated until delivery of the infant.

    00:15 And then stage 3, starts with the delivery of the infant and ends with the delivery of the placenta.

    00:22 Now here's a clinical pearl.

    00:23 There are three signs to let you know the placenta is ready to deliver.

    00:27 First is lengthening of the umbilical cord.

    00:30 As you start to apply your gentle traction as the placenta separates, the cord will lengthen.

    00:36 Next, there's a gush of blood again from the placenta separating from the uterus.

    00:41 And then the uterus becomes more globular as the placenta separates and it's no longer at the fundus, the uterus becomes more globular.

    00:50 So what's the process for delivery of the placenta.

    00:53 We apply gentle downward traction with counter traction on the uterus.

    00:57 That counter traction is very important.

    00:59 Failure to do so can result in uterine inversion.

    01:02 where the uterus turns inside outside and that's a surgical emergency.

    01:07 Sometimes there can be delays in the delivery of the placenta.

    01:09 And that most common way is related to an abnormal placentation.

    01:13 So that's going to be our placenta acreta, increta or percreta.


    About the Lecture

    The lecture Labor Stage 3: Placenta Delivery by Veronica Gillispie, MD, FACOG is from the course Intrapartum Care.


    Included Quiz Questions

    1. Physiologic separation of the placenta from the uterus
    2. A sure indication of umbillical cord tear
    3. Evidence of uterine rupture
    4. A sign of placenta accreta
    5. Evidence of a succenturiate placental lobe
    1. Application of gentle downward traction on the umbilical cord and counter-traction on the suprapubic uterus
    2. Application of gentle upward traction on the umbilcal cord and counter-traction on the fundus of the uterus
    3. Application of gentle downward traction on the umbilical cord with massage of the fundus of the uterus
    4. Application of rotational traction on the umbilical cord
    5. Application of gentle upward traction the umbilical cord while avoiding pushing on the uterus

    Author of lecture Labor Stage 3: Placenta Delivery

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG


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