Placental expulsion
As the afterbirth after the actual birth of a child or young animal still to be born fetal membranes and placenta ( placenta) are referred to in humans and most other mammals. Also, the process of rejection as such is called afterbirth.
Placenta in humans
After birth, the placenta must be checked for completeness by a midwife or doctor. In special cases a curettage for the prevention of complications is necessary.
Possible complications of placenta remaining radicals are as an inflammation of the uterus ( endometritis ), and puerperal fever. Whether or residual tissue is in the uterus after birth, can be determined in general by means of ultrasonography; in particular can be very easily detected by the Doppler method, if still perfused placental tissue is in it.
The period of the child's birth until about 2 hours after expulsion of the placenta is called postpartum or Plazentarperiode. The duration of which is usually 10 to 20 minutes. The uterus (womb) is contracted by the release of prostaglandins. This causes a detachment of the placenta through which reduces in adhesive surface. Often, the placenta detaches first centrally, rare is the solution starting at its edge. Exceeds the replacement time is 30 minutes or there is major blood loss, it is manually or instrumentally nachgeholfen (see afterbirth handles ).
The Nachgeburtsblutung 250-500 ml of blood are those that are physiologically lost in the postpartum period. Any further blood loss is, however, referred to as rebleeding. To avoid large losses of blood, a bolus of 3 IU oxytocin can be administered intravenously after the cord has been cut. Oxytocin causes a strong uterine contraction, thus promoting hemostasis.
With the birth of the placenta complete the postpartum period begins, through the hormonal changes triggered by the production of milk is set in motion.
Afterbirth Handles
The following handles are used for manual placental attachment:
- Baer'scher handle ( most common method):
- Credé Handle: From the outside of the uterus with the hand is enclosed so that four fingers slip behind the uterus, while the thumb comes to rest on the front. It is now replaced with the next contraction by pressure the placenta.
- Cord traction ( detachment by train on the umbilical cord ):
Basically, a wait action in the afterbirth is advised. Each intervention requires an indication. Even the diagnosis of most solution characters and early abnabeln belong to measures that violate the principle of manipulating the uterus as little as possible! Without cutting the cord, the cord traction is not possible. " To rub " One woe is harmful, that provokes but possibly partial contraction, partial detachment of the placenta and thus increased bleeding! If anything controlled cord traction is applied to above the symphysis to keep back -up to a uterus to prevent inversion ( inversion of the uterus to the outside) the abdominal hand.
Placental abruption characters
The following characters can conclusions as to whether the placenta begins postpartum ( after birth) to solve this:
- Küstner characters (including umbilical cord characters):
- Schröder character (" eight shape " / " hourglass " of the uterus ):
- Ahlfeld character type II:
- Strassmann character ( rather uncertain):
- After load:
Afterbirth in animals
As in humans one or more young animals still placenta and fetal membranes are repelled also in most mammals after the actual delivery. The placenta may be delayed depending on the species to a few days after birth. In nature, the afterbirth is generally eaten due to the high -protein content by the mother or by scavengers.
In domestic animals must, similar to humans, for possible complications ( placenta ) in connection with the afterbirth be taken, such as Geburtsrehe in horses. Also the transmission of various infectious diseases through the afterbirth is possible.