Third stage of labour

Created by: libsd
Created on: 24-01-19 10:29

What is the third stage

From the birth of the baby to the complete expulsion of the placenta and membrane

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What happens

seperation, descent and expulsion of the placenta and membrane, control of haemorrhage from the placental site, encompasses examination of the genital tract following delivery

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Process

Baby born, marked reduction in size of uterus, size of placental site reduced, inelastic placenta squeezed, blood in intervillous space forced back into veins of spongy layer od decidua basilis, veins become tense and congestes, blood cant drain back

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continued

congested veins burst, small amount of blood released causing villi to sheer off from the spongy layer of decidua, placenta is stripped, placenta propelled into uterine segmentr

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Shultze expulsion

Placenra descends into lower uterine segment membranes peel away from lower uterine wall

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Mathew duncan

placenta descends into vagina assisted by gravity, with membranes behind

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Physiological signs

pressure, trickle of blood, cord lengthens, uterus becomes globular/hard/high/mobile/ballotable

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Concerns

500=800ml/min blood through placental site, pph is one of the main causes of maternal mortality and morbidity

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Control of bleeding

living ligatures cause powerful contraction and retraction, the walls exert pressure on placental site, blood clots, oxcytocin and breastfeeding helps control bleeding

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Expectant managemnet

cord is clamped once placenta is being delivered, 30 minutes, longer, may increase pph, gravity aids delivery

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Active management

Oxytocic drug given, cord clammed, placenta delivered by cct with counter traction on the fundus

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Examination

3 vessels in cord, cord incertion, completness of maternal side, examination of membranes, ebl

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Other cards in this set

Card 2

Front

What happens

Back

seperation, descent and expulsion of the placenta and membrane, control of haemorrhage from the placental site, encompasses examination of the genital tract following delivery

Card 3

Front

Process

Back

Card 4

Front

continued

Back

Card 5

Front

Shultze expulsion

Back

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Third stage of labour