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Related Experiment Videos

Down-up sequential separation of the placenta.

A Herman1, A Zimerman, S Arieli

  • 1Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel. aherman@asaf.health.gov.il

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
|March 19, 2002
PubMed
Summary

Placental separation during the third stage of labor is typically a multiphasic process, usually starting from the lower pole and moving upwards. Understanding this pattern aids in managing potential complications.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Reproductive Biology

Background:

  • The third stage of labor, the period after delivery of the baby until the expulsion of the placenta, involves placental separation from the uterine wall.
  • Understanding the dynamics of placental separation is crucial for identifying and managing potential complications such as postpartum hemorrhage.

Purpose of the Study:

  • To characterize the typical patterns of placental separation during the third stage of labor.
  • To investigate the sequence, starting point, and progression of placental separation using real-time ultrasound.

Main Methods:

  • Continuous real-time ultrasound imaging was employed during the third stage of labor in 101 normal deliveries.
  • The sequence of placental separation was meticulously recorded to determine if it was multiphasic, its initiation site, and progression mode.

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Main Results:

  • Placental separation was predominantly multiphasic in 97 out of 101 cases.
  • For uterine wall placentas (n=92), separation typically initiated at one pole and progressed sequentially, most commonly starting from the lower pole (83/92 cases, 90.2%).
  • Fundal placentas (n=9) exhibited multiphasic separation beginning at their poles, with the fundal portion separating last.

Conclusions:

  • Placental separation is generally an orderly, multiphasic event, predominantly initiating from the lower pole and progressing upwards.
  • Fundal placentas demonstrate a distinct separation pattern, initiating at the poles and concluding with the fundal portion.
  • Recognizing these separation patterns can assist in identifying pregnancies at risk for third-stage complications and in managing pathological cases.