Class 1

Question 1

What are two other names for postpartum?

Answer 1

Puerperium or Postnatal Period

Question 2

What is the medical definition of postpartum?

Answer 2

After birth until 6 weeks, when the organs become non pregnant. A well known midwife considers the postpartum period to last as long as your baby is in diapers and you are up in the night.

Question 3

What is one of the most detrimental aspects of postpartum?

Answer 3

Isolation. Education and relationship are important factors of the postpartum time.

Question 4

When does the 3rd stage of delivery start?

Answer 4

Upon the completion of the birth of the baby and ends with the birth of the placenta

Question 5

What is the time from for the 3rd stage of labor?

Answer 5

As early as 3 minutes and up to an hour later. The earlier the placenta comes, the more toned the uterus.

Question 6

What are the 2 sub stages of the third stage?

Answer 6

Placental Separation and Placental Expulsion

Question 7

What brings on the third stage?

Answer 7

contractions

Question 8

What is the anatomy and physiology of the 3rd stage?

Answer 8

Pushing contractions that last 2-3 minutes. The next may occur 3-5 minutes later. Contractions continue every 4-5 minutes until the placenta detaches and is expelled.

Question 9

What are the competing hormones of the 3rd stage?

Answer 9

Oxytocin Increase (breastfeeding and nearness of the baby increase this); and Adrenalin decrease (keep the mother warm)

Question 10

What are the normal signs of placental separation?

Answer 10

Gush of blood, cord lengthens, change in shape of uterus, change in position of uterus

Question 11

What is the Shultz mechanism?

Answer 11

The fetal side of the placenta and the bag surrounding it. Most of the time the placenta comes out with this side presenting.

Question 12

What is the Duncan Mechanism

Answer 12

This is more messy, the mother’s side comes out first. There is often the presentation of more blood.

Question 13

What is one of the biggest issues for postpartum women in the hospital?

Answer 13

cord clamping. Most hospitals try to do this as soon as possible.

Question 14

How long have most studies shown that it is good to allow the cord to pulse?

Answer 14

1-3 minutes

Question 15

What are reasons for cutting the cord before the placenta is delivered?

Answer 15

Cord wrapped around the baby; 3rd stage hemorrhage; monozygotic twin birth that keeps the second baby from descending; extensive NRP methods

Question 16

What is the HYpovolemia, Hypervolemia controversy?

Answer 16

The idea that the baby will get too little blood from cutting the cord too soon, or too much blood if it is left too long.

Question 17

What are methods to aids in delivering the placenta?

Answer 17

Tincture of Angelica; squal position and toilet delivery; empty bladder; sterile glove and follow up vaginal wall; active management

Question 18

What is the placental deliver and inspection?

Answer 18

Check for pieces of the placenta missing; check for 2 arteries and one cord; as the placenta comes out, the caregiver twirls it so the membranes come out.

Question 19

What needs to happen after the placenta is delivered?

Answer 19

Immediate Uterine Massage, Examine the Placenta

Question 20

Battle Door

Answer 20

placenta side insertion; if you are pulling on this cord it is more likely to snap

Question 21

Velamentous Cord Insertion

Answer 21

Trunkal arteries, that should be protected by the Wharton’s Jelly int he cord, are exposed.

Question 22

Placenta with a Succenturiate Lobe

Answer 22

an extra love that grows to the side; can sometimes have no veins, just attached to the wall, and can come out with the chorion.

Question 23

Parenchyma

Answer 23

meaty part of the maternal side

Question 24

Cotelydons

Answer 24

any subdivision of the maternal side of the placenta

Question 25

What are placental customs in the US?

Answer 25

Throw it away; planting it; placental encapsulation; placental art

Question 26

What does the newborn need in the third stage?

Answer 26

Kept next to mom (non-separation) dried and warm (Best way through mother’s body temp); put to the breast.

Question 27

What are the three types of invasive placenta?

Answer 27

Placenta Accreta, Placenta Increta, Placenta Percreta

Question 28

Placenta Accreta

Answer 28

The placenta grows into the uterine wall

Question 29

Placenta Increta

Answer 29

The placenta grows into the uterine muscle

Question 30

Placenta Percreta

Answer 30

The placenta grows entirely through the uterine wall

Question 31

Uterine Inversion

Answer 31

Occurs when the entire uterus turns inside out and protrudes through the cervical os (incomplete), into the vagina (complete), or beyond the vulva (prolapsed).

Question 32

What is the result of Uterine inversion?

Answer 32

Usually life threatening hemorrhage and shock. More common in multigravidae or cord traction done without fundal pressure.

Question 33

Retained placenta

Answer 33

Placenta that has not separated and shows no visible sign of hemorrhage. The woman can start bleeding heavily a few days later.

Question 34

Third stage hemorrhage

Answer 34

Most common cause is due to the mismanagement of the third stage. It is due to partial separation of the placenta.