RE: [ozmidwifery] sharing an unusual placenta question - ideas please

[Sally Westbury]

I agree it is probably a large succenturiate lobe.   I have seen only 2 placenta’s like this.   One was only discovered in retrospect after a straight forward birthing process.   The other had heavy bleeding and it was a bit confusing because although the midwife easily felt the placenta below the cervix it was still not being birthed. The woman was also experiencing a lot of pain (first birth for this mother). The midwife did attempted to assist the birth of the placenta, believing that it had separated and was being held up at the cervix, with gentle cord traction, but it did not come easily. Some Syntocinon and controlled cord traction did help the placenta birth but it was still difficult, with more cord traction than ‘usual’ (remembering that we are used to physiological 3rd stage) and severe pain for the birthing woman: it was very odd. Only on looking at the placenta did we get any explanation of what was happening. I think that one lobe of the placenta was sitting in the cervix causing the pain whilst the rest was not separated causing bleeding. This is of course the worry that the placenta is less likely to separate in one nice clean action and so bleeding is probably something to be alert for and therefore a increased risk of PPH.   Despite this 2nd experience I would probably not give routine Syntocinon (I would have it drawn up) but would use the watch closely and act quickly if my head, heart or gut alerted me.   Sally Westbury Homebirth Midwife   "It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her."    -Judy Slome Cohain -----Original Message----- From: owner-[EMAIL PROTECTED] [mailto:owner-[EMAIL PROTECTED]] On Behalf Of Julie Clarke Sent: Sunday, 20 July 2003 7:54 PM To: [EMAIL PROTECTED] Subject: [ozmidwifery] sharing an unusual placenta question - ideas please   Hi all I have been asked an unusual “placenta” question tonight that I hope you can all help me with…   The woman is expecting her first baby – there are no complications or problems with this pregnancy – there has been no bleeding episodes during the pregnancy so far- however the ultrasound has revealed what appears to be 2 placentas joined by a blood vessel. The questions are:  Would we expect there to be a greater risk of 3rd stage complications such as excessive bleeding? Could the blood vessel rupture either during the last few weeks of pregnancy or during the labour, birth or 3rd stage? Has anyone ever encountered this type of situation before and if so what was your experience?   Would this be a strong case for having the Syntocinon injection given routinely? Is there a greater risk of pph?   Warm hug to all, Julie