Complications Of Third Stage Of Labour and Management - A Brief Overview

Complications Of the Third Stage Of Labour

Third Stage Of Labour:

In the first two stages of labor, the baby is delivered completely. The third stage of labor extends from delivery of the baby to the delivery of the placenta and this stage lasts for 15-30 minutes. Normally placenta is delivered within 30 (max) minutes of delivery of the baby.

Complications Of the Third Stage Of Labour:

1. Retained Placenta

Trapped Placenta: The placenta detaches from the uterus but becomes trapped due to the cervix closing. Partial Accreta:  The placenta grows into and becomes deeply attached to the uterus. This prevents detachment. Placenta Adherens:  The muscular layer of the uterus fails to contract and placenta remain attached to the uterus.

2. Primary Post Partum Hemorrhage

3. Uterine Inversion

4. Uterine Rupture

General Management:

1. Stop the bleeding by massaging the uterus to cause it to contract or by bimanual compression.
2. Uterine contraction is maintained by ergometrin and high intravenous dose of syntocinon (March 2012).
3. The bladder must be emptied.
4. Prostaglandin F2x must be injected systemically (March 2012)

Specific Management:

Retained Placenta:
Trapped Placenta:
Trapped placenta often follows the intravenous administration of ergometrin when the onset of uterine contraction is very rapid.

Clinical Findings Of Trapped Placenta:

1. A small Contracted Fundus
2. Vaginal Bleeding
3. Cord Lengthening – Cord lengthening indicates that placenta has been separated but is trapped inside the uterus.

Management:

Controlled Cord Traction is done, which encourages the cervical dilation. With Controlled cord traction, the umbilical cord is lightly pulled on to help the body expel the placenta.
See also:

Placenta Adherens - What is placenta Accreta – Increta and Percreta )
Primary Post Partum Hemorrhage PPH- Causes and Management)
Uterine Rupture – Causes – Scar dehiscence
Uterine Inversion.