The Management of the Third Stage of Labor with Special Reference to the Manual Removal of the Placenta

1915 ◽  
Vol 149 (2) ◽  
pp. 305
Author(s):  
Ahlfeld
Keyword(s):  
Special Reference ◽  
Manual Removal ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage

scholarly journals On the history of management of the third stage of labor in Kazan (to the 155th anniversary of the birth of Professor V.S. Gruzdev)

2021 ◽  
Vol 102 (2) ◽  
pp. 249-257
Author(s):  
L A Kozlov
Keyword(s):  
High Efficiency ◽  
Historical Study ◽  
Manual Removal ◽  
The Third ◽  
Obstetrics And Gynaecology ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Primary Literature ◽  
History Of ◽  
Speed Up

The article aims to show the experience of the Kazan Obstetrics and Gynaecology Clinic named after V.S. Gruzdev for replacing the obstetric operation manual removal of the placenta with other techniques to prevent serious postpartum complications. Research methods the historical study of primary literature sources. Manual removal of the placenta always associated with the risk of infection and developing puerperal sepsis. That is why obstetricians are constantly looking for a replacement for this operation. In 1895, even in the pre-Kazan period of work, professor Gruzdev successfully performed a method of inserting saline into the umbilical vessels to speed-up placental separation in the third stage of labor. While working in Kazan, on his proposal, doctor L.S. Sidorova (1936), and then Professor P.V. Manenkov (1942, 1948, 1955) and doctor M.V. Korotkova (1958) thoroughly studied and implemented the method of Budimilich in the work of the maternity ward of the clinic. This method involves replacing the saline solution with the crude alum solution. The second measure, preventing hemorrhage in the third stage of labor and avoiding manual removal of the placenta, was the successfully testing intravenous pituitrin (oxytocin) injection by Z.N. Yakubova, completed with the defense of her doctoral dissertation (1962). The high efficiency of these methods allowed us to recommend to them for widespread obstetric practice.

scholarly journals Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Fiona Urner ◽  
Roland Zimmermann ◽  
Alexander Krafft
Keyword(s):  
Maternal Morbidity ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Active Management ◽  
Retained Placenta ◽  
Manual Removal ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Maternal Morbidity And Mortality

The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity.

Cord Traction Versus Manual Removal for Placental Delivery during Cesarean Section

2020 ◽  
Vol 103 (9) ◽  
pp. 850-855
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Umbilical Cord ◽  
Current Knowledge ◽  
Skills Training ◽  
Major Surgery ◽  
Manual Removal ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage

Background: Cesarean section is the most common major surgery performed on pregnant women around the world. It is necessary to apply the practical skills training and current knowledge, especially in the procedure that would need to help keep mothers alive and the fetus safe. Objective: To study the efficacy of the umbilical cord traction versus manual removal for placenta delivery in the third stage of labor during the cesarean section. Materials and Methods: The present study was a retrospective comparative study conducted in Srisangwornsukhothai Hospital between January 2017 and January 2020. The purposive sample size was calculated by using a power of 80%, with a significant level of 5%. One hundred twenty pregnant women were divided into two groups, sixty pregnant women each, the cord traction as the first group and the manual removal as the second group for placental delivery during the cesarean section. The significance of the two groups were compared by using the independent t-test (p<0.05), 95% confidence interval (CI), and the Mann-Whitney U test. Results: Several outcomes of the umbilical cord traction were better than the manual removal, such as decrease time of the operation and a statistically significant decrease in hemoglobin (p<0.001, 0.049, respectively). However, there was not a statistically significant decrease of blood loss, fever after surgery, or the length of stays (p=0.839, 0.056, 0.175, respectively). Only one outcome, the time of the third stage of labor, was slightly more than the manual removal group for placental delivery during the cesarean section with statistically significance (p=0.003). Conclusion: The umbilical cord traction maneuver for the delivery of the placenta had more advantages than the manual removal maneuver. This technique should be a recommendation during the cesarean section. Keywords: Cesarean section, Umbilical cord traction, Placental delivery

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