- Placenta and membranes need to be checked after the birth to make sure they are complete
- If pieces of placenta or membranes left inside the uterus can’t contract completely
— can cause postpartum haemorrhage (significant bleeding)
Do not
- Do not dispose of placenta until you have asked family for advice, if not sending to hospital/pathology
- Placenta may have cultural or personal significance and family may want to take it
home
Do first
- If woman going to hospital — send placenta with her
- Double bag then put in pathology transport container with ice brick
- Make sure it is labelled
Check
- If woman less than 37 weeks pregnant or showing signs of infection — eg fever or pus/discharge
on membranes, offensive odour from placenta
- Take swabs from both foetal (outside) and maternal (inside) sides of membranes and
send for MC&S
- Send placenta to pathology, even if woman not going to hospital
- Make sure pathology test form is sent with the placenta — medical consult to find out what tests to order
- If abnormalities in the placenta, or complications in the pregnancy — medical consult — placenta may need to be sent for histopathology
Look at cut cord
- Usually 3 blood vessels — Figure 3.16
- If only 2 blood vessels — medical consult for baby — may be associated with kidney, heart or other abnormalities
Look at placenta — foetal (cord) side up
- Put placenta on table with foetal (cord) side up — should be smooth and shiny — Figure 3.17
- Hold placenta up by cord and check membranes are intact — Figure 3.18
- There are 2 layers of membranes
- Amnion (membrane on foetal side) is easy to tear
- Chorion (membrane on maternal side) is a bit tougher and thicker
- If any holes, tears, ragged edges or missing membrane — Figure 3.19 — medical consult
Look at placenta — maternal side up
- Lay placenta flat on table with maternal side up — check it is complete
- If any pieces of placenta missing — Figure 3.20 — medical consult