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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.
Along with placenta previa and uterine rupture it is one of the most common causes of vaginal bleeding in the later part of pregnancy. [6] Placental abruption is the reason for about 15% of infant deaths around the time of birth. [ 2 ]
The vessels are hence normally protected by Wharton's jelly, which prevents rupture during pregnancy and labor. [10] In velamentous cord insertion, the vessels of the umbilical cord are improperly inserted in the chorioamniotic membrane, and hence the vessels traverse between the amnion and the chorion towards the placenta .
Alcohol: Use during pregnancy can cause fetal alcohol syndrome and fetal alcohol spectrum disorder. [67] Tobacco use: During pregnancy, causes twice the risk of premature rupture of membranes, placental abruption and placenta previa. [68] Also, it increases the odds of the baby being born prematurely by 30%. [69]
Associative prevention mechanisms can be a method of minimising the risk of developing the disease, within early stages of pregnancy. Placental syndromes include pregnancy loss, fetal growth restriction, preeclampsia, preterm delivery, premature rupture of membranes, placental abruption and intrauterine fetal demise.
Improving nutrition of female, both before and during pregnancy, is important for reducing the risk of obstructive labor. [11] Creating education programs about reproduction and increasing access to reproductive services such as contraception and family planning in developing areas can also reduce the prevalence of obstructed labor.
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]
The placenta, once ejected from the womb, has no circulation and quickly dies; [4] and within 3–10 days postpartum the umbilical cord dries and detaches from the baby's belly. [2] The practice requires the mother and baby to be home bound as they wait for the placenta and umbilical cord to dry, decompose, and separate from the baby. [10]