59414 Delivery of placenta (separate procedure)

Name of the Procedure:

Delivery of Placenta (separate procedure)

Summary

The delivery of the placenta is a subsequent step following childbirth where the placenta is expelled from the uterus. It is a critical process that helps ensure the uterus is free of any remaining tissue that could cause complications.

Purpose

This procedure is performed to remove the placenta after the birth of the baby, ensuring that all placental tissue is expelled to prevent bleeding and infection.

Indications

• Retention of placenta post-delivery
• Excessive bleeding post-delivery
• Signs of placental fragmentation detected

Preparation

• The patient may need to empty their bladder.
• Diagnostic assessments like ultrasound may be conducted to check the placental position.
• Patients may receive oxytocin to expedite uterine contractions.

Procedure Description

1. After the baby is delivered, the healthcare provider will monitor for signs indicating placenta readiness.
2. The provider may help the placenta to detach through gentle tugging on the umbilical cord or applying mild pressure to the uterus.
3. Uterine massage or additional procedures like manual removal might be required if the placenta does not naturally expel.
4. Tools such as clamps and sterile gloves are typically used.
5. Local anesthesia might be utilized if manual removal is needed.

Duration

The procedure typically takes about 5-30 minutes following the birth of the baby.

Setting

The procedure is generally performed in a hospital maternity ward or labor and delivery room.

Personnel

• Obstetrician or midwife
• Labor and delivery nurses
• Possible anesthesiologist if additional intervention is required

Risks and Complications

• Excessive bleeding (postpartum hemorrhage)
• Infection
• Uterine inversion (rare)
• Need for additional surgeries or interventions in case of complications

Benefits

Ensures complete removal of the placenta, reducing risks of postpartum hemorrhage and infection. Benefits are realized immediately following the procedure.

Recovery

• Close monitoring for signs of excessive bleeding or infection.
• Pain management as needed, typically through medications.
• Recovery usually happens within a few days, with most activities resuming gradually.

Alternatives

• Natural management: Waiting for the placenta to deliver without assistance.
• Manual removal under anesthesia if less invasive methods are ineffective.

Patient Experience

Patients might experience cramping or discomfort during the procedure, similar to strong menstrual cramps. Effective pain management and comfort measures, including breathing techniques and supportive care, are provided to ease discomfort.