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AIDS
2 min Introduces self INTRODUCTION:
and the topic to Good morning, I am
the group. Nidhi Sharma, student
of M.Sc. (N) 2nd Year
today I am here to
present a topic which
is very important as it
allows us to examine
the placenta for any
abnormality so that it
can be managed to
initial stages.
The placenta is a
temporary organ that
connects the
developing fetus via
the umbilical cord to
the uterine wall to
allow nutrient uptake,
thermo-regulation,
waste elimination,
and gas exchange via
the mother's blood
supply; to fight
against internal
infection; and to
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OBJECTIVE TEACHER
ACTIVITY AND AV
AIDS
produce hormones
which support
pregnancy.
1 min Defines placenta. DEFINITION OF PLACENTA: Student teacher Define placenta.
Placenta is a choriodecidual structure (forms from chorion, defines placenta with
maternal decidua and maternal blood), which helps in the help of ppt.
maintenance of pregnancy and development of fetus. The placenta
is partly fetal and partly maternal in origin. It connects closely with
mother’s circulation to carry out functions, which the fetus is
unable to perform for itself during intrauterine life. The survival of
the fetus depends on the integrity and efficiency of the placenta.
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OBJECTIVE TEACHER
ACTIVITY AND AV
AIDS
2 min Defines placental DEFINITION OF PLACENTAL EXAMINATION: Student teacher Define placental
examination. Placental examination is an important procedure of Labour room defines placental examination
which is done to identify any abnormalities, lesions and prepare examination with the
material for histological examination. help of ppt.
or
2 min Enlists about the ARTICLES REQUIRED FOR EXAMINATION OF PLACENTA, Student teacher List down the
articles required MEMBRANES AND CORD: enlists the articles articles required
for examination required for for examination
of placenta, S.NO. ARTICLES RATIONALE examination for of placenta,
membranes and 1. Placenta with cord-1 For examination placenta, membranes membranes and
cord. 2. Sink with tap water For cleaning placenta of and cord. cord.
fresh blood and blood
clots
3. Gloves- 1 pair To protect hands of the
examiner
4. Mask To protect face of the
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OBJECTIVE TEACHER
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AIDS
examiner from spilled
blood
5. Plastic apron- 1 To protect clothing of the
examiner
6. Basin To keep placenta with
cord for examination
7. Mackintosh To spread on table so as to
prevent soiling on table
8. Bowl with cotton To separate the
balls- 2 or 3 membranes
9. Weighing scale To measure the weight of
placenta
10. Inch tape/ Scale To measure the length and
diameter
11. Yellow poly bag To discard the placenta
10 min Explains about STEPS OF PROCEDURE FOR EXAMINATION OF PLACENTA: Student teacher Redemonstrate
the steps of 1. Wear the Personal Protective Equipments. explains about the the steps of
procedure for 2. Keep placenta with cord in the basin and take it to the sink steps of the examination
examination of and wash thoroughly under running water. procedure with the placenta.
placenta. 3. Fill basin with clean water and wash until all the blood clots help of placenta.
are removed.
4. Hold placenta by the cord thus allowing the membranes to
hang.
5. Spread out the hand inside the membranes through the
hole from which the baby was delivered. This aids in
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inspection of membranes. If the membranes are complete,
strip the amnion from the chorion and see if both
membranes are present.
6. Spread the mackintosh on the table surface and lay the
placenta on a flat surface.
7. Examine for both the maternal and fetal surfaces one after
the other in a good light.
8. MATERNAL SURFACE:
I. Take the placenta in both cupped hands and check for the
completeness of placenta. Broken pieces of cotyledons
must be replaced before assessing the maternal surface.
II. Place the placenta on the mackintosh and count the lobes
also called cotyledons of placenta which normally
numbered to be 16-20. These cotyledons are separated by
sulci (furrows) in to which decidua dips down to form septa.
III. Normally maternal surface is dark red in colour but white
patches/ infarctions may be seen on maternal surface that
may be due to the disposition of lime salts. The edges of the
maternal surface form a uniform circle.
9. FETAL SURFACE:
It is white and shiny surface. Branches of umbilical veins and
arteries are visible spreading out from the insertion of the
umbilical cord.
IV. Separate amnion and chorion using the probe. Peel off
amnion from the fetal surface till the insertion of cord to
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ACTIVITY AND AV
AIDS
see the chorionic plate from which the placenta develops.
V. Note the insertion of the umbilical cord. It is normally
central but it may be laterally inserted.
VI. Measure the length of the umbilical cord. It is normally 50
cm and ranges from 30-100 cms. A cord measuring less
than 40 cm is considered as short. A very long cord may
lead to true knots in the cord and it may become wrapped
around the neck or body of the fetus resulting in occlusion
of the blood vessels during labour.
VII. Clean the stump of the cord and look for vessels. It has two
arteries and one vein. Note for the knots in the cord.
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VIII. Note for the false knots in the cord, it is comprised of
Whartson’s jelly, a gelatinous substance formed from
mesoderm.
10. Weigh the empty basin and then again weigh the basin with
placenta in it and calculate the actual weight of placenta.
Weight of the placenta is about 1/6th of the baby weight at
term. Weight of placenta may also be affected by the time
of clamping. Early clamping of cord results in more
placental weight while late clamping leads to less placental
weight, owing to amount of blood retained in placenta.
11. Record the findings of examination of placenta and
membranes and an estimate of blood loss in mother’s note
12. Discard placenta in yellow bag after the procedure is over.
Discarded placenta is sent for incineration.
13. Perform the aftercare of articles and replace all the articles
to utility.
2 min Describe about ANATOMICAL VARIATIONS OF THE PLACENTA AND CORD: Student teacher Explain the
the anatomical Placenta succenturiate: A small extra lobe is present, describes about the anatomical
variations of the separate from main placenta and joined to it by blood anatomical variations variations of the
placenta and vessels, which run through the membrane to reach it. of the placenta and placenta and
cord. Risks associated with placenta succenturiate : cord. cord.
Increased risk of PPH due to retained placental
tissues.
Increased incidence of vasa previa
Subinvolution
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AIDS
Uterine sepsis
Polyp formation