How to examine a placenta after the delivery of placenta inorder to prevent complications that might arise from retained product of conception

1. Placenta examination
Performed as soon as possible after birth, examination of the placenta is a unique
opportunity to explore and understand the intrauterine environment, and also provides a
record of events that may be associated with adverse pregnancy outcomes
Purpose
 To assess for completeness
 To assess for normalcy
 To identify abnormalities
Requirements
 Apron
 A pair of gloves
 Large bowl
 A running water
Procedure
 Explain the procedure to the client/spouse and ask if they want to observe it
 Wash hands, wear an apron and gloves
 Estimate blood loss before examination under running water.
 Weigh placenta
 Examine the placenta under running water/bowl
 Spread out the placenta with the foetal surface uppermost inside a sink under
running water or in a large bowl containing adequate water.
Note the
Colour/appearance
Size
Shape
 Examine the umbilical cord, noting the length, point of insertion,number and
distribution of blood vessels , presence of any knots

2.  Note the state of membrane, strip chorion from amnion
 Turn to the maternal surface
 Hold the cord to lift the placenta up ; observe the colour of the membranes
 Spread out the membranes to look for extra vessels, count lobes for
completeness,tear or hole on the surface.
 Examine the cotyledons to ensure that they are all present
 Pack placenta after examination and place in a suitable container
 Remove gloves and apron
 Wash hands
 Tidy up the environment
 Record and report any identified abnormalities