Definition: Retained placenta is diagnosed after failure to deliver the placenta within 60 minutes of the birth of the baby.

Guidelines

• If the placenta is undelivered after 30 minutes consider emptying bladder, breast feeding and encourage an upright position.
• If placenta still not delivered a diagnosis of retained placenta is made.
• Establish IV access and obtain samples for FBC and group & save.
• Inform midwife in charge and medical staff.
• Prepare and transfer woman to theatre for manual removal of placenta (MROP).
• Measure and accurately record blood loss.
• Document third stage completion time.
• Monitor post-operative period – vital signs, fundus, blood loss and fluid balance.
• Antibiotic cover – Cefuroxime 1.5mg IV x 1 dose.
If significant bleeding occurs inform senior midwifery and medical staff immediately and institute obstetric haemorrhage protocol

References:

http://www.clinicalguidelines.scot.n...OR-LBS-037.pdf

Attached Images

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