What does applying traction to the placenta mean?
Controlled cord traction (CCT) is traction applied to the umbilical cord once the woman’s uterus has contracted after the birth of her baby, and her placenta is felt to have separated from the uterine wall, whilst counter-pressure is applied to her uterus beneath her pubic bone until her placenta delivers.
Why is forceful pulling of the cord during placental delivery contraindicated?
Pulling also carries a slight risk of tearing the cord and of causing a rare but life-threatening condition — uterine inversion, in which the organ is pulled inside out or even out of the body. The study concluded that the oxytocin injection was the most important thing a midwife could do to stop bleeding.
What is the correct technique in the delivery of the placenta Why?
Such techniques include finger splitting versus scissor cutting of incision, in situ stitching verses exteriorization and stitching of uterus , and finally spontaneous or manual removal of the placenta. Two common methods used to deliver the placenta at CS are cord traction and manual removal.
What effect can excessive traction have on the umbilical cord during placenta delivery?
Controlled cord traction may result in complications such as uterine inversion, particularly if traction is applied before the uterus has contracted sufficiently, and without applying effective counter‐pressure to the uterine fundus.
Can pulling on the placenta cause a hemorrhage?
The placenta has many blood vessels that bring the nutrients from the mother to the developing baby. If the placenta starts to pull away during pregnancy, these blood vessels bleed. The larger the area that pulls away, the greater the amount of bleeding.
Why controlled traction and counter traction are very important prior to the delivery of the placenta?
CCT has the advantage of reducing the risk of manual removal of the placenta in some circumstances, and evidence suggests that CCT can be routinely offered during the third stage of labour, provided the birth attendant has the necessary skills. CCT should remain a core competence of skilled birth attendants.
What are the two types of placenta separation?
There are two main types of placental abruption:
- Revealed – bleeding tracks down from the site of placental separation and drains through the cervix. This results in vaginal bleeding.
- Concealed – the bleeding remains within the uterus, and typically forms a clot retroplacentally.
Is it bad to pull the placenta out?
Retained portions of the placenta after delivery can lead to dangerous bleeding and infection. A doctor will typically recommend surgical removal as quickly as possible. However, sometimes the placenta is so attached to the uterus that it isn’t possible to remove without also removing the uterus (hysterectomy).