Methods of placental separation
There are
two methods of separation and expulsion of the placenta.
Shultze Method: 80%: This is
the most common method. Inthis method separation starts from the centre of the
placenta and with the aid of Retroplacenta clot the placenta drop into the
lower uterine segment or into the vagina. During delivery the fetal surface
appears first at the vulva followed by the membranes. There is minimal blood
loss with this method. The 3rd stage is neat
Mathews Duncan Method 20%: In this
method separationstarts at the edge and slides down sideways. It comes through
the vulva
with the lateral border first, like a button through a button hole. The
maternal surface is seen first at the vulva. There is trickling of blood
throughout the third stage. The third stage .is messier.
Control of bleeding: the
Contraction and retraction of theuterine muscle fibers that bring about
separation of the placenta also act as “living Ligatures” by compress ing the
blood vessels and controlling the bleeding. The clothing mechanism is of little
value untill later when contractions are much less. The opposite wall are now
in contact and apply further pressure on the placenta site.
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