14.
11: Performing an Exanmination of PlacentaDEFINITIONA thorough inspection and examination of
the placenta and membranes, s0on after expuision, tor its completen.
normalcy.leteness andPURPOSES2 To make sure that placenta is of normal size, shape, consistency and
weight.. 1o ensure that the entire placenta and membranes have been expelled and no part has been
retained.3. To detect abnormalities such as infarctions, calcification or additional lobes.
4. To ascertain the length of the cord, number of blood vessels and site of insertion of the cord.
5. To check weight of placenta and measure length of cord.ARTICLES1. Placenta in a bowl.2. A washable
surface to lay the placenta for examination.
3. A weighing machine.
4. Measuring tape.
5. Kidney tray.
6. Pair of clean gloves.PROCEDURENursing actionRationale1. Don gloves.Protects nurse from
contamination.Hanging membranes will provide a better view to check s2. Using gloved hands hold the
placenta by the cord allowing
the membranes to hang (twisting the cord twice around the completeness.
fingers will provide a firm grip).If the membrances are not torn into pieces, a single roune
hole can be identified clearly.3. Identify the hole through which the baby was delivered.Insert hand
through the hole and spread out the fingers to
4.The position of cord insertion and the course of blood vess
can be noted in this position.view the membranes and the blood vessels [Figure 14.11(a)].
Nursing actionna NurSIngRemove the and from inside the membranes and lay thelacenta ona flat:
surface with the fetal surface up. Identify
mpleteness and presence of abnormal vessels indicating5.Rationalerd insertion [Figure 14.11
(b)].Normally the cord is inserted in the center of placenta. Lateral
or velamentous insertion may be noted.the site ofe the two membranes, amnion and chorion for6.
Examine thsuccenturiate lobe.
ert the placenta, expose the maternal surface and removeAmnion is shiny and chorion is shaggy.
Amnion can be peeled
from the chorion upto the umbilical cord.Invany clots present [Figure 14.11(c)1.Figure 14.11(b): Fetal
surface of placentaFigure 14.11(c): Maternal surface of placentaEnsures that no part of the placenta or
membranes is left
inside the uterus.8. Examine the maternal surface by spreading it in the palms
of your two hands and placing the cotyledons in close
approximation (any broken fragments must be replaced
before accurate assessment is made).Assess for presence of abnormalities such as infarctions,
calcifications or succenturiate lobes..inspect the cut end of the umblical cord for presence of three
umbilical vessels [Figure 14.11(d)].Two arteries and one vein should normally be seen. Absences
of an artery may be associated with renal abnormalitiesUmbilical arteriesUmbilical veinFigure 14.11(d):
Cross-section of umbilical cordtended against ta graduated surface/side of the weighingasure the ength
of the umbilical cord by holding it11.Scale.be added to get the Average length of the cord is 50 cm.ength
of the cord on the baby may be
otal length where applicableConhe leng
Conta...Nursing actionRationaleWeigh the placenta by placing it on the weighing scale meant Normally
the placenta weighs about 1/6 th of the baby's
12.for the purposeweight.13 Place the placenta in the bin for proper disposal.14. Clean the area used for
examination of the placenta and
membranes, the weighing scale and the bowl.15. Remove gloves and wash hands.Record in the patient's
chart, the findings of placental
examination and weight of the placenta, length of the cord
and any special observations made.16.Acts as a communication between staff members.
