Examination of Placenta

Definition:-
 It means accurate observation and examination of the
placenta after it is expulsion for their completeness.

Objectives:
1. To ensure that the placenta is complete.
2. To detect early any abnormality of the placenta,
membranes and , or cord such infarction, calcification, or
consistency and weight.
3. To treat early any abnormality to prevent complications.
4. To decrease the incidence of maternal mortality.

Equipment:
1. Round basin or large iodine bowl.
2. Tray.
3. Measuring tape.
4. Clean gloves.
5. A weighing machine.
Procedure Rationale
I) Preparation phase
1. Wash hands. To prevent cross infection.
2. Prepare the necessary equipment To be ready for conducting the
procedure.
3. Explain the procedure to the mother To gain cooperation
4. Wear the gloves. To avoid cross infection
II) Implementation phase
I- Placenta deliver:-
1. As the placenta delivers, Hold it in both
hands and gently turn it until the
membranes are twisted slowly.
2. Pull to complete the delivery.
3. Move membranes up and down until they
deliver, if he membranes tears, gently
examine the upper vagina and cervix.
4. Wearing sterile gloves and uses a sponge
forceps to remove any remaining pieces of
membranes.
II- placenta examine:- To examine it, to remove any
1. Receive the placenta in a round basin and blood clots and to have more
wash it carefully under running water. accurate view.
2. Carry the placenta in your cupped hand - To observe it carefully.
(Fig.1) OR B. Place the placenta on a flat - To observe all the placenta l
surface e.g. the tray or table with the maternal lobes or cotyledons.
surface facing you. (fig.2):-

(placenta on flat surface)

(placenta in cupped hand) (Fig. 1) (Fig. 2)
3. Inspect the maternal surface carefully: - To detect any deviation from
normal (e.g. missing lobe)
 Shape: normally disk or round shape
 Size: normally 20-22cm in diameter and
2-2.5 cm in thickness.
 Weight: 500gm by placing placenta on a
weighting machine.
4. Turn the placenta to the fetal surface. - To observe it and to detect
any abnormality in the cord,
arteries, vein and
membranes.
5.Inspect the fetal surface carefully - To detect and treat early
To observe and check: deviation from normal and
o Observe the insertion of the cord should prevent any complication.
be centrally.
((Fig .4) (umbilical cord)
o Check of the presence of two arteries and
one vein in the cord. (Fig .4)
o Check the cord for it is length normally
49-50 CM.
o Check the presence of any knots.
(fig.5&6) Normally the cord should be
free from any knots.

(Fig.6) ( false knot)

(Fig.5) ( true knot)
14.Inspect the membranes carefully by - To see if they are complete
grasping and approximating the edges. and no missing part.
III) Evaluation phase:-
15.After placental examination , discard it in
the appropriate place
16. Clean the equipment. - To be ready for sterilization
17. Put the equipment in it is place. - To be ready for use later on.
18.Wash hand properly - To avoid contamination and
l or infection.
19.Record and report the following :
1. Date of delivery.
2. Time of placental expulsion.
3. Time of placental examination.
4. Any abnormalities