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Retained Placenta
Retained placenta is a condition in which all or part of the placenta or membranes remain in the uterus during the third stage of labour. Retained placenta can be broadly divided into: * failed separation of the placenta from the uterine lining * placenta separated from the uterine lining but retained within the uterus A retained placenta is commonly a cause of postpartum haemorrhage, both primary and secondary. Retained placenta is generally defined as a placenta that has not undergone placental expulsion within 30 minutes of the baby’s birth where the third stage of labor has been managed actively.Maternity - Prevention, Early Recognition & Management of Postpartum Haemorrhage (PPH)
From Department of Health, NSW. 21-Oct-2010


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Placenta
The placenta is a temporary embryonic and later fetal organ that begins developing from the blastocyst shortly after implantation. It plays critical roles in facilitating nutrient, gas and waste exchange between the physically separate maternal and fetal circulations, and is an important endocrine organ, producing hormones that regulate both maternal and fetal physiology during pregnancy. The placenta connects to the fetus via the umbilical cord, and on the opposite aspect to the maternal uterus in a species-dependent manner. In humans, a thin layer of maternal decidual ( endometrial) tissue comes away with the placenta when it is expelled from the uterus following birth (sometimes incorrectly referred to as the 'maternal part' of the placenta). Placentas are a defining characteristic of placental mammals, but are also found in marsupials and some non-mammals with varying levels of development. Mammalian placentas probably first evolved about 150 million to 200 millio ...
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Uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uterus is a hormone-responsive sex organ that contains glands in its lining that secrete uterine milk for embryonic nourishment. In the human, the lower end of the uterus, is a narrow part known as the isthmus that connects to the cervix, leading to the vagina. The upper end, the body of the uterus, is connected to the fallopian tubes, at the uterine horns, and the rounded part above the openings to the fallopian tubes is the fundus. The connection of the uterine cavity with a fallopian tube is called the uterotubal junction. The fertilized egg is carried to the uterus along the fallopian tube. It will have divided on its journey to form a blastocyst that will implant itself into the lining of the uterus – the endometrium, w ...
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Haemorrhage
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a puncture in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties (by comparison, blood donation typically takes 8–10% of the donor's blood volume). The stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery. Types * Upper head ** Intracranial hemorrhage – bleeding in the skull. ** Cerebral hemorrhage – a type of intracranial hemorrhage, bleeding within the brain tissue itself. ** Intracerebral hemorrhage – bleeding in the brain caused by the rupture ...
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Placental Expulsion
Placental expulsion (also called afterbirth) occurs when the placenta comes out of the birth canal after childbirth. The period from just after the baby is expelled until just after the placenta is expelled is called the third stage of labor. The third stage of labor can be managed actively with several standard procedures, or it can be managed expectantly (also known as ''physiological management'' or ''passive management''), the latter allowing the placenta to be expelled without medical assistance. Although uncommon, in some cultures the placenta is kept and consumed by the mother over the weeks following the birth. This practice is termed placentophagy. Physiology Hormone induction of placental separation As the fetal hypothalamus matures, activation of the HPA axis (hypothalamic-pituitary-adrenal axis) initiates labour though two hormonal mechanisms. The end pathway of both mechanisms leads to contractions in the myometrium, a mechanical cause of placental separation, w ...
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Ergometrine
Ergometrine, also known as ergonovine and sold under the brand names Ergotrate, Ergostat, and Syntometrine among others, is a medication used to cause contractions of the uterus to treat heavy vaginal bleeding after childbirth. It can be used either by mouth, by injection into a muscle, or injection into a vein. It begins working within 15 minutes when taken by mouth and is faster in onset when used by injection. Effects last between 45 and 180 minutes. Common side effect include high blood pressure, vomiting, seizures, headache, and low blood pressure. Other serious side effects include ergotism. It was originally made from the rye ergot fungus but can also be made from lysergic acid. Ergometrine is regulated because it can be used to make lysergic acid diethylamide (LSD). Ergometrine was discovered in 1932. It is on the World Health Organization's List of Essential Medicines. Medical uses Ergometrine has a medical use in obstetrics to facilitate delivery of the placenta a ...
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Cord Traction
Cord or CORD may refer to: People * Alex Cord (1933–2021), American actor and writer * Chris Cord (born 1940), American racing driver * Errett Lobban Cord (1894–1974) American industrialist * Ronnie Cord (1943–1986), Brazilian singer * Cord McCoy (born 1980), American bull and saddle bronc rider * Cord Meyer (1920–2001), American CIA official * Cord Parks (born 1986), American professional football player * Cord Phelps (born 1987), American professional baseball player * Cord Pool, guitarist for American red dirt metal band Texas Hippie Coalition * Cord Widderich (died 1447), German pirate Arts and entertainment * Cord (band), a British rock group * ''Cord'' (film), a 2000 film starring Daryl Hannah and Jennifer Tilly * Edwin Cord, a Marvel Comics character * Cordero "Cord" Buchanon, a fictional character in the American soap opera '' One Life to Live'' CORD * Canadian Organization for Rare Disorders, a non-profit health organization * Christian Outreach for R ...
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Placenta Accreta
Placenta accreta occurs when all or part of the placenta attaches abnormally to the '' myometrium'' (the muscular layer of the uterine wall). Three grades of abnormal placental attachment are defined according to the depth of attachment and invasion into the muscular layers of the uterus: # ''Accreta – chorionic villi'' attached to the myometrium, rather than being restricted within the ''decidua basalis''. # ''Increta – chorionic villi'' invaded into the ''myometrium''. # ''Percreta – chorionic villi'' invaded through the '' perimetrium'' (uterine serosa). Because of abnormal attachment to the myometrium, placenta accreta is associated with an increased risk of heavy bleeding at the time of attempted vaginal delivery. The need for transfusion of blood products is frequent, and surgical removal of the uterus (hysterectomy) is sometimes required to control life-threatening bleeding. Rates of placenta accreta are increasing. As of 2016, placenta accreta affects an estimated ...
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Fetal Membranes
The fetal membranes are the four extraembryonic membranes, associated with the developing embryo, and fetus in humans and other mammals.. They are the amnion, chorion, allantois, and yolk sac. The amnion and the chorion are the chorioamniotic membranes that make up the amniotic sac which surrounds and protects the embryo. The fetal membranes are four of six accessory organs developed by the conceptus that are not part of the embryo itself, the other two are the placenta, and the umbilical cord. Structure The fetal membranes surround the developing embryo and form the fetal-maternal interface. The fetal membranes are derived from the trophoblast layer (outer layer of cells) of the implanting blastocyst. The trophoblast layer differentiates into amnion and the chorion, which then comprise the fetal membranes. The amnion is the innermost layer and, therefore, contacts the amniotic fluid, the fetus and the umbilical cord. The internal pressure of the amniotic fluid causes the ...
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Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hemoly ...
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