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Manual Removal of Placenta Extraction of Placenta

Assist For Manual Removal Of Placenta / Clot

Placenta

The placenta (also known as afterbirth) is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, provide thermo-regulation to the fetus, waste elimination, and gas exchange via the mother’s blood supply, fight against internal infection and produce hormones to support pregnancy.

Purpose of Manual Removal of Placenta

Retained placenta is potentially life threatening.

Scope of Manual Removal of Placenta

Management of 3rd stage of labor.

Definition-Manual Removal of Placenta

Manual placenta removal is a procedure to remove a retained placenta from the uterus after childbirth.  It is usually carried out under anesthesia or more rarely, under sedation and analgesia.  A hand is inserted through the vagina into the uterine cavity and the placenta is detached from the uterine wall and then removed manually.  If the placenta does not separate easily from the uterine surface, there may be a placenta accrete.

Applicable Areas

Gyneac & Obstetric Department.

Responsibility

Consultant, Medical Officer, Staff Nurse, Auxillary Nurse Midwife and Head Nurse.

Procedure

  • Assist the Doctor to perform the procedure by –
  • Providing lithotomy position to the patient.
  • Reassuring the patient.
  • Monitoring the vital signs closely.
  • Handing over plastic apron / sterile gloves to consultant.
  • Providing adequate light.
  • In case, if the patient needs to be shifted to O.T.
  • Inform the O.T. nurse to keep the theatre ready and ensure that the anesthetist is informed.
  • Give pre-medication as ordered.
  • Inform the blood bank / O.T. Nurse to keep the blood ready for the patient.
  • Obtain written consent from patient and her husband. If the husband is not available, then any close relative.
  • Complete the formalities of theatre booking.
  • Change the patient into theatre clothes and shift on trolley to the theatre.
  • Hand over the patient to the theatre nurse.
  • Inform the post-operative unit to receive the patient from the O.T.
  • Provide post-natal care.
  • Assist in suturing of cervical / vaginal tear.
  • Ensure that the patient is explained about the nature of intervention by the concerned gynecologist.
  • Obtain written consent.
  • Give lithotomy position.
  • Assist doctor throughout the procedure like extended episiotomy, suturing of the tear with suture material.
  • Reassure the patient and closely monitor the vital signs.
  • As discussed, provide post-natal care.

Documentation

  • Nurse’s Observation Sheet.
  • Billing Data Record.