What is the test of peeling vegetables, supporting vegetables, checking the placenta to do?

This is an automatically translated article.

The article is professionally consulted by an Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Phu Quoc International General Hospital
The test of placental detachment, vegetable support, and placental examination is a procedure after each normal birth, to check for placenta, residual placenta, or abnormalities so that it can be handled promptly.

1. Peeling test

The placental abruption test is done after the pregnancy has come out about 20-30 minutes, to check for placental abruption.
The doctor will use the edge of the hand to rest on the edge of the pubic bone, press on the lower part of the uterus and push the uterus up.
The placenta has not yet shed : if the pedicle is pulled up with the movement of the fundus. Vegetables have peeled: if the vegetable stalks will stand still or move a little. The placenta drops down to the vagina : if the vegetable stalk drops lower. After the placenta comes out, the woman continues to rub the fundus of the uterus through the abdominal wall until the uterus contracts. In the first 2 hours, you can massage the uterus every 15 minutes, to ensure that the uterus contracts well, you can stop the uterine massage.
In addition, if after 30 minutes, the placenta has not peeled off or there is heavy bleeding, it is necessary to conduct an artificial placental detachment.

2. Support vegetables

After the placenta has peeled off, the doctors will proceed to support the placenta. The doctor will place his hand on the pregnant woman's abdomen to see the contraction of the uterus. If the uterus is not contracting well, it can be massaged outside to make the uterus contract more tightly.
Steps to carry out placenta support include:
Place one hand on the mother's lower abdomen, spread the thumb on one side and the other four fingers on the opposite side. Gently push the uterus towards the navel and hold it in place. The other hand needs to grab the placenta and pull with increasing force. Initially, pull the placenta downwards, then horizontally, and finally upward, so that the placenta slowly comes out. When the placenta is about to come out, the umbilical cord should be lowered so that the placenta and placenta can easily fall out. If the vegetable film does not come out, hold the vegetable cake and twist it many times to slowly release the membrane. Assess uterine contractility by palpating the lower abdomen, observing the vulva for bleeding.

3. Check the vegetable cake

Checking the vegetables is the last resort to check for any residual or abnormal vegetables. After the vegetable cake comes out, it will be placed on a tray. The nurse will hold the umbilical cord and lift the placenta up and down. Then observe:
Tear hole of the membrane: the membrane is enough to have a round hole. If there is a small tear, there is a good chance that little of the endometrial lining is left. Vascular: Observe the blood vessels of the membrane to detect the placenta or the placenta. Place the vegetable cake on the tray with its cusp face up. Clean the top, remove the blood clots to observe the vegetable zone.
Normal vegetable zone: smooth, smooth and crimson. Defect: the part of the placenta may be left in the uterus. The purpose of placental examination is to avoid residual placenta in the uterus. If there is residual placenta or bleeding, it is necessary to control the uterus and perform artificial vegetable extraction.

In summary, the test of placental abruption, placenta delivery, and placental examination is an indispensable procedure of every delivery, helping the mother to remove the placenta and check to assess whether the placenta is still in the uterus to take measures. treatment according to the treatment protocol.
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