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Delay of a placenta and fetal membranes


The delay of a placenta and fetal membranes  — duration of the afterbirth period (the birth of a placenta and fetal membranes) makes 10 — 12 min., the most admissible — 30 min.
Frequency of these complications makes about 10%.

Symptoms of the Delay of a placenta and fetal membranes:

The doctor or the midwife carry out a constant bypass, watching emergence of signs which indicate separation of a placenta from a uterus wall (Schröder's signs, Kyustnera — Chukalova, Alfelda, etc.).

If at the next check positive signs of department of a placenta come to light, to the woman in labor suggest to be extinguished, and the afterbirth is born independently.

Defect of placental fabric or its additional segment;
Delay in a cavity of the uterus of fetal membranes;
Dense attachment of an afterbirth - lack of signs of department of an afterbirth and bleeding within 30 minutes after the fruit birth;
The true increment of an afterbirth - germination of fabrics of an afterbirth in a muscular layer of a uterus, can be diagnosed only when carrying out attempt of manual department and allocation of an afterbirth.

Повреждение vasa previa в момент разрыва плодных оболочек

Damage of vasa previa at the time of a rupture of fetal membranes

Reasons of the Delay of a placenta and fetal membranes:

Risk factors:
Defect of an afterbirth in labor;
True increment of an afterbirth;
Dense attachment of an afterbirth;
The previous Cesarean section or other surgical interventions on a uterus;
Multigiving birth;
Anomalies of development of a placenta;
Excessive tractions for an umbilical cord in the III period of childbirth, especially, at its attachment in an uterine fundus;
Hyperthermia in labor;
Long anhydrous interval (more than 24 hours).

Treatment of the Delay of a placenta and fetal membranes:

If the afterbirth independently does not leave, then resort to its allocation in the manual way. There are several such ways: Abuladze's way, Krede's way — Lazarevich, Genter's way.

If at observation of the woman in labor it is not possible to find signs of department of a placenta, then waiting tactics of maintaining this period of childbirth should not exceed 30 min., despite the absence of bleeding and good shape of the woman in labor.

In order to avoid the possible complications leading to a big loss of blood it is necessary to resort to manual department of a placenta.

Drugs, drugs, tablets for treatment of the Delay of a placenta and fetal membranes:

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