Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur
COLLEGE OF HEALTH SCIENCES

Name of Student: Date:

Year and Section: Grade:

PROCEDURE CHECKLIST: PLACENTAL EXAMINATION

Instruction: Below is the grading scale which will be used in rating your
performance.
5 - Excellent - 96– 100
4 - Very Satisfactory - 91 – 95
3 - Satisfactory - 86 – 90
2 - Fair - 81 – 85
1 - Needs Improvement 75 – 80

ASSESSMENT:
The placenta is a fetal organ of pregnancy, responsible for providing
nutrition and oxygen to the fetus as well as excretory functions. A one-
minute examination of the placenta performed in the delivery room provides
information that may be important to the care of both mother and infant.
The findings of this assessment should be documented in the delivery
records. During the examination, the size, shape, consistency, and
completeness of the placenta should be determined, and the presence of
accessory lobes, placental infarcts, hemorrhage, tumors and nodules
should be noted. The umbilical cord should be assessed for length,
insertion, number of vessels, thromboses, knots and the presence of
Wharton's jelly. The color, luster and odor of the fetal membranes should
be evaluated, and the membranes should be examined for the presence of
large (velamentous) vessels.

PLANNING:

Assemble equipment:

1. Flashlight/penlight
2. gloves
3. basin/bowl
4. syringe with needle
5. washable surface to lay the placenta/ large tray
6. Weighing machine
7. measuring tape
8. kidney tray

PREPARATION 5 4 3 2 1 REMARKS
KNOWLEDGE:
1. What is placental examination?
2. Describe maternal and fetal
surface of the placenta
3. State the purposes in performing
the procedure.
4. Enumerate the different placental
interpretation on. A. placental
size, placental consistency and
surfaces, umbilical cord, cord
vessels, and free fetal
membranes,
SKILLS:
PROCEDURE
1. Explain the procedure to the
parents
2. Wear an apron and gloves
3. Ensure that there is adequate
lighting to check the placenta
4. Prepare a flat surface with
protection to avoid blood spillage
5. Prepare a syringe and needle if for
cord sample
6. Lay the placenta fetal side
uppermost, note the size, shape,
smell, and color
7. Examine the cord, note the length,
insertion point and presence of true
knot or thrombi
8. Inspect the umbilical cord vessels
at the cut end at the furthest point
from the placenta.
9. Observe the fetal side for
irregularities
10. Lift the placenta up the cord,
and observe for the membrane
completeness
11. Return the placenta to the
surface and spread out the
membranes to look for extra
vessels, lobes or holes in the
surface
 12. Separate the amnion from
the chorion by pulling the amnion
back over the base of the umbilical
cord to ensure both are present.
13. Turn the placenta over to
inspect the maternal surface.
14. Examine the cotyledons,
ensuring all are present, noting the
size and any areas of infarction,
blood clots or calcification
15. Retain the clot to make an
accurate assessment of blood loss.
16. Observe that the lobes of a
complete placenta fit neatly
together without any gaps with the
edges forming a uniform circle
17. Where there is suspicion that
the placenta and/or membrane are
incomplete, they should be kept for
further inspection and referred to
the duty obstetrician.
18. Inform the mother of your
findings
19. Complete documentation in
the woman’s health care record.

ATTITUDE:
1. Performs the procedure in a relaxed,
systematic manner.
2. Willingly accepts corrections and
demonstrations.
3. Observes proper decorum as a
mature student nurse
4. Saves time and effort in performing
the procedure
5. Well-groomed and neat
Reports to the study areas promptly
and on time
6. Has initiative, is resourceful and uses
time creatively

Date/Time: ___________________________

Printed name & Signature of C.I. ____________________________