Completion of delivery and inspection
To ensure complete expulsion of the fetal membranes, the parturient woman is advised to elevate her pelvis while resting on her feet. Gravity helps the placenta pull the membranes along, facilitating their complete separation from the uterine walls.
After the delivery of the placenta, the physician performs a thorough visual inspection of:
- Maternal surface and the site of umbilical cord insertion.
- Fetal membranes for integrity.
- Accessory lobes: their presence is indicated by vessels running from the edge of the placenta to the membranes.
If a tissue defect or signs of a torn-off lobe are found, emergency manual exploration of the uterine cavity is indicated.
Inspection of the birth canal
Following antiseptic treatment of the external genitalia, an inspection of the soft tissues is performed: the cervix, vagina, and vulva. The procedure is carried out strictly under anesthesia. The goal is to identify tears and perform subsequent surgical repair.
Early postpartum period
From the moment the placenta is delivered, the woman attains the status of puerpera. She remains in the delivery room for dynamic observation for 2 hours. Main monitoring parameters:
- Blood pressure and heart rate.
- Uterine tone.
- Objective assessment of blood loss (gravidometric method).
If parameters are stable, after 2 hours the puerpera is transferred to the postnatal ward.
Impact of pain on the labor process
Severe pain triggers the release of endogenous catecholamines, which negatively affects the body:
- Cardiovascular system: increased blood pressure, tachycardia, elevated systemic vascular resistance.
- Respiratory system: hyperventilation leading to hypocapnia and the risk of fetal hypoxia.
Inadequate pain relief can provoke uterine inertia or labor dystocia, as well as lead to the development of fetal acidosis due to increased oxygen consumption.
"Inspection – Anesthesia – Assessment": Inspect the placenta, anesthetize the canal inspection, and assess blood loss in the first 2 hours.
Class and exam questions
What to do if a defect is found during placental inspection?
If a defect of the placenta, membranes, or an accessory lobe is detected, emergency manual exploration of the uterine cavity must be performed to remove residual tissues.
How to properly measure postpartum blood loss?
The gravidometric method is used: blood is collected in a graduated vessel, and used sheets are weighed to accurately determine the volume.
Why is it important to anesthetize the inspection of the birth canal?
Inspection of the cervix and vagina is a painful manipulation, therefore, for the patient's comfort and the quality of the procedure, it is performed strictly under anesthesia.
What else to study on this topic
- Pathophysiological mechanisms of pain impulse transmission (from receptors to the cerebral cortex).
- Biochemical pain mediators in the myometrium (serotonin, bradykinin, prostaglandins).
- Requirements for an ideal method of labor analgesia.
- Differences in the causes of pain in the first and second stages of labor.
- Effect of hypocapnia on uteroplacental blood flow.
Master the entire topic in the "Obstetrics and Gynecology" course
This is a summary. The course covers everything tested in classes and exams.
- Complete guide on "Placental separation" and 973 more pages of the subject
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 21 video lessons on the subject
Other topics in the "Obstetrics" section
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.