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Manual placenta removal is the evacuation of the placenta from the uterus by hand. [6] It is usually carried out under anesthesia or more rarely, under sedation and analgesia . A hand is inserted through the vagina and cervix into the uterine cavity and the placenta is detached from the uterine wall and then removed manually.
Gross pathology of a uterus which has been opened to show a placental abruption, with a hematoma separating the placenta from the uterus. In the vast majority of cases, placental abruption is caused by the maternal vessels tearing away from the decidua basalis, not the fetal vessels. The underlying cause is often unknown.
Ischemic placental disease leads to the attachment of the placenta to the uterine wall to become under-perfused, causing uteroplacental ischemia. Where the term overarches the pathology associated with preeclampsia , placental abruptions and intrauterine growth restriction (IUGR). [ 3 ]
In 2015 about 6.5 million cases of obstructed labour or uterine rupture occurred. [5] This resulted in 23,000 maternal deaths down from 29,000 deaths in 1990 (about 8% of all deaths related to pregnancy). [2] [6] [9] It is also one of the leading causes of stillbirth. [10] Most deaths due to this condition occur in the developing world. [1]
Couvelaire uterus (also known as uteroplacental apoplexy) [1] is a rare but not a life-threatening condition in which loosening of the placenta (abruptio placentae) causes bleeding that penetrates into the uterine myometrium forcing its way into the peritoneal cavity. This condition makes the uterus very tense and rigid.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening or opening) of the cervix and surgical removal of sections and/or layers of the lining of the uterus and or contents of the uterus such as an unwanted fetus (early abortion before 13 weeks), remains of a non-viable fetus, retained placenta after birth or abortion as well as any abnormal tissue which may be in the ...
Retained placenta is a condition in which all or part of the placenta or membranes remain in the uterus during the third stage of labour. [1] Retained placenta can be broadly divided into: failed separation of the placenta from the uterine lining; placenta separated from the uterine lining but retained within the uterus