- published: 09 Apr 2016
- views: 3987
Placental expulsion (also called afterbirth) occurs when the placenta comes out of the birth canal after childbirth. The period from just after the baby is expelled until just after the placenta is expelled is called the third stage of labor.
It begins as a physiological separation from the wall of the uterus. The placenta is usually expelled within 15–30 minutes of the baby being born.
Maternal blood loss is limited by contraction of the uterus following birth of the placenta. Normal blood loss is less than 600 mL.
The third stage of labor can be managed actively, or it could be managed expectantly (also known as physiological management or passive management), the latter allowing the placenta to be expelled without medical assistance.
Active management routinely involves clamping of the umbilical cord, often within seconds or minutes of birth. It may also involve giving oxytocin via intramuscular injection, followed by cord traction to assist in delivering the placenta. The oxytocic agents augment uterine muscular contraction and the cord traction assists with rapid birth of the placenta. However, premature cord traction can pull the placenta before it has naturally detached from the uterine wall, resulting in hemorrhage.