The place did not work out after childbirth. What is afterbirth? Afterbirth after birth

Probably each of us has heard about the placenta, but usually even pregnant women have a very general idea of its purpose and function. Let's talk about this amazing organ in more detail.

The placenta connects mother and child, it is needed to nourish the baby, after birth it will no longer be there - as a rule, this is the only knowledge about the placenta at the beginning of pregnancy. As it enlarges and after undergoing an ultrasound, the expectant mother learns the following about the placenta: “the placenta is located high (or low)”, “its degree of maturity is now such and such.” Then the placenta, like the baby, is born. True, this event is no longer so significant for many mothers against the backdrop of the arrival of the long-awaited baby.

The placenta does not appear immediately. It is formed from the chorion - the embryonic membranes of the fetus. The chorion looks like many elongated outgrowths of the membrane surrounding the unborn child, which penetrate deep into the wall of the uterus. As pregnancy progresses, the outgrowths of the chorion increase in size and turn into the placenta; it is finally formed towards the end.

The new organ has the appearance of a disk, or cake (that’s how the word placenta is translated from Latin - “cake”). One side of the placenta is attached to the uterus, and the other “looks” towards the baby. It is connected to the fetus by the umbilical cord. There are two arteries and one vein running inside the umbilical cord. Arteries carry blood from the fetus to the placenta, and veins carry nutrients and oxygen from the placenta to the baby. The umbilical cord grows with the child and by the end of pregnancy its length is on average 50-55 cm.

Place and dimensions

During pregnancy, as the baby grows, the placenta grows along with it. In addition, its location in the uterus also changes. K, when the placenta reaches full functional maturity, its diameter is 15-20 cm, and its thickness is 2.5-4.5 cm. After this stage of pregnancy, the growth of the placenta stops, and then its thickness either decreases or remains the same.

During a normal pregnancy, the placenta is usually located in the area of the fundus or body of the uterus, along the back wall, with a transition to the side walls - that is, in those places where the walls of the uterus are best supplied with blood. The placenta is located less frequently on the anterior wall, as it is constantly growing. The location of the placenta does not affect the development of the child.

There is a condition called placenta previa, when it is located in the lower parts of the uterus along any wall, partially or completely blocking the area of the internal os. If the placenta only partially covers the area of the internal os, then this is an incomplete presentation. If the placenta completely covers the area of the internal os, then this is complete. In such cases, doctors are afraid of bleeding during childbirth, so they especially carefully monitor the course of pregnancy and childbirth. There is an even low location of the placenta, when its edge is lower than it should be normally, but does not overlap the area of the internal pharynx.

The placenta is capable of moving (migrating); there is even such a term as “placenta migration”. The movement occurs due to the fact that the lower segment of the uterus changes its structure during pregnancy, and the placenta grows towards the better blood-supplied areas of the uterus (towards the fundus of the uterus). Typically, “placenta migration” occurs over 6-10 weeks and is completed by. Therefore, in I, the diagnosis of “low placenta” should not frighten. Simultaneously with the enlargement of the uterus, the placenta rises.

What is the placenta for?

Gas exchange occurs through the placenta: oxygen penetrates from the mother's blood to the baby, and carbon dioxide is transported in the opposite direction.
The baby receives nutrients through the placenta and gets rid of its waste products.
The placenta is able to protect the body of the unborn child from the adverse effects of many substances that enter the body of a pregnant woman. Unfortunately, the placental barrier is easily overcome by drugs, alcohol, nicotine, components of many medications and viruses.
Many hormones are also synthesized in the placenta (human chorionic gonadotropin, placental lactogen, estrogens, etc.).
The placenta, as an immune barrier, separates two genetically foreign organisms (mother and child) and prevents the development of an immune conflict between them.

Degree of maturity of the placenta

The placenta grows and develops along with the baby. Using ultrasound, you can determine the degree of its maturity. There are four degrees of placental maturity, and each corresponds to a certain stage of pregnancy.

0 degree of maturity occurs up to .

III degree of maturity can be determined starting from .

If the degree of maturity changes prematurely, this may indicate premature maturation of the placenta. It may occur due to a disturbance in the blood flow in the placenta (for example, as a result of late toxicosis, anemia), or it may be an individual feature of the body of a pregnant woman. Therefore, you should not be upset if an ultrasound suddenly reveals premature maturation of the placenta. The main thing is to look at the child’s development: if his condition does not suffer, then most likely everything is normal with the placenta.

Birth of the placenta

After the baby is born, the 3rd stage of labor begins - the afterbirth period. The placenta, membranes and umbilical cord together form the afterbirth, which is expelled from the uterus 5-30 minutes after the baby is born.

First, the afterbirth contractions begin: the uterus contracts, including the placenta attachment site, which is called the placental platform. The placenta itself cannot contract, so it moves away from the place of attachment. With each contraction, the placental area becomes smaller, and finally the placenta separates from the wall of the uterus. The doctor examines the postpartum woman and, making sure that the placenta has separated from the uterus, gives permission to push.

The birth of the placenta is usually painless. After this, the doctor must examine the placenta and determine whether there is any damage to the surface of the placenta and whether all its parts have completely left the uterus. This examination is necessary to ensure that there are no parts of the placenta left in the uterus. If the integrity of the placenta is compromised, then a manual examination of the uterus is performed under anesthesia to remove remnants of placental tissue.

Based on the state of the “born” placenta, one can judge the course of pregnancy (whether there were any infectious processes, etc.). Pediatricians will need this information to know what characteristics the baby may have. And, accordingly, to prevent possible problems as quickly as possible.

Sometimes the placenta is designed in such a way that even if part of it remains in the uterus, this is not visible upon examination - there are no defects on the placenta, the edges are even. A few days after childbirth (usually this happens in the first 7 days), abdominal pain appears and bleeding increases. Then we can assume that part of the placenta still remains in the uterus. In such a situation, you should immediately consult a doctor and go to the hospital, where they will perform curettage of the uterus.

In cultures of different nations, there has always been a respectful attitude towards the placenta. This was explained by the fact that the placenta, in modern terms, is the carrier of the same genetic information as the mother and baby. Therefore, earlier, when maternity hospitals did not yet exist, the placenta was not thrown away, but was usually buried in the ground. Today in maternity hospitals it is disposed of as biological waste. But if the woman wishes, she can always pick her up from the maternity hospital.

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A woman's body is full of secrets and mysteries. Surely everyone knows that only a representative of the weaker sex can give birth to their own kind. In this case, you need to have established hormonal levels and the menstrual cycle. During childbirth, doctors may distinguish several periods. One of them involves separation of the placenta. This is what will be discussed in this article. You will learn what afterbirth is and what it is needed for. We will also talk about the normal course of this period and its possible deviations.

Pregnancy and childbirth

Before we say what an afterbirth is, it is worth getting acquainted with some features of the female body. About once a month, a representative of the fairer sex experiences a follicle rupture and, as a consequence, ovulation. The released cell is directed towards the reproductive organ. This is where conception most often occurs. The fertilized egg descends into the uterine cavity and is securely attached to its wall. This is where pregnancy will develop. Every day the fetus increases in size and acquires new skills.

When the baby is ready to be born, the first stage of labor begins. Most often, this process occurs between 38 and 42 weeks. It is worth noting that the baby may appear at an earlier time. In this case, he may need qualified medical assistance.

First and second stages of labor

At this stage, the fetus is expelled from the cavity of the reproductive organ. Normally, such manipulation occurs naturally. However, in some cases, medication or even surgery may be required. The average duration of the first and second periods in total ranges from 2-4 to 10-16 hours.

Third stage of labor: what is the afterbirth?

Immediately after the baby leaves the birth canal, the third stage of labor begins. It is characterized by the expulsion of remaining membranes from the uterine cavity. What is a formation that forms in the first third of pregnancy. It is the placenta that supplies the fetus with blood, oxygen and many other nutrients. Also, the afterbirth can perform a protective function during the baby’s stay in the womb. The placenta reliably protects the baby from toxic substances and some medications.

The afterbirth got its name due to the fact that it leaves the cavity of the genital organ last. Nature intended this so that throughout the entire process the baby could receive oxygen and the substances he needs from the mother’s body.

How does the placenta expel?

Discharge of the placenta can occur in two ways: natural and forced. Much depends on the structure of the reproductive organ, diseases of the woman’s reproductive system, complications during pregnancy, and so on. The way in which the baby is born also plays a big role.

Natural childbirth

If a woman does not have indications for surgical intervention, then she goes through all stages of labor. When the baby leaves the uterine cavity, the discharge of the placenta begins. This process may take from 10 to 30 minutes.

After birth, the baby is placed near the entrance to the vagina and wait until the umbilical cord stops pulsating. After this, the baby is separated from the mother. In the first minutes, the uterus begins to actively shrink and decrease in size. All this contributes to the separation of the placenta from its walls.

Within a few minutes after the baby is separated from the mother, the doctor checks whether the placenta is ready to leave its place. To do this, the obstetrician or gynecologist places the edge of his hand on the lower area of the peritoneum and applies light pressure. If the hanging umbilical cord is not pulled back, then the birth of the placenta can begin.

All this time, the uterus undergoes contractions. A new mother may simply not feel this, since their intensity is much lower than during childbirth. The doctor pays attention to when the next contraction will begin and asks the woman to push a little. It is enough for a woman to take a deep breath and tense her abdominal wall. The very next minute the placenta will come out of the uterine cavity. You can find a photo of this formation in the article.

C-section

If a woman gives birth to a baby by cesarean section, then the placenta may be separated somewhat differently. A photo of the operation is presented to your attention.

During the manipulation, the doctor cuts the uterine cavity and removes the baby from it. Immediately after this, the uterus may begin to shrink, but this does not always happen. Due to injury to blood vessels and muscle walls, the contractility of the organ may be temporarily lost. In this case, the doctor has to separate the placenta using his hands and special tools.

The doctor holds the wall of the uterus with one hand, and with the fingers of the other he slowly and carefully separates the formation.

Examination of the placenta

The placenta after childbirth is subjected to careful study. If everything went well and there were no complications, doctors place the placenta on a large metal plate. In this case, the mother's side should be at the top.

Through careful examination, the degree of maturity of the organ is assessed. Normally, the age of the placenta is grade 1 or 2. If during pregnancy a woman had to behave differently and use a lot of medications, then there may be a third degree of development of the placenta.

The afterbirth is also examined for damage after childbirth. If they are detected, we can talk about some complications. The doctor measures the placenta using a special tape and records its dimensions in the birth chart. All this plays a big role in describing the process.

What does the afterbirth look like for most women? This is a large disk that is penetrated by many vessels and veins. The color of this formation can range from blue to bright red. All this is considered a variant of the norm. The umbilical cord also departs from the placenta, which normally has three main vessels. It is examined in the same way and all data obtained is recorded.

Possible problems

The placenta after childbirth (a photo of the formation is presented in the article) does not always come out as intended. In some cases, problems or complications arise. One of the most common pathologies is retention of placenta. Also, the placenta can adhere to the cavity of the reproductive organ or detach prematurely. Let's look at the main complications and ways to eliminate them.

Retained placenta

If half an hour after the birth of the child there is no separation of the placenta, then we can talk about its tight attachment. In this case, one part of the organ often falls away and bleeding occurs. In this case, a woman may complain of mild painful sensations, which an inexperienced doctor mistakes for uterine contractions.

If the placenta lingers in the cavity of the reproductive organ, the obstetrician or gynecologist tries to separate it manually. It is worth noting that during manipulation it is forbidden to tug or pull the umbilical cord. The doctor inserts his hand into the uterine cavity and slowly tries to separate the placenta. This manipulation can be performed under general or local anesthesia. However, some medical institutions do not provide such services, so manual extraction of the placenta occurs “for profit”. When the placenta is separated, the reproductive organ and vaginal walls are carefully examined for debris or injury.

Ingrown placenta

This pathology most often occurs in women who have previously undergone a cesarean section or any other operations that left scars on the uterine area. If the placenta attaches in the suture area, fusion of the walls may occur. It is worth noting that this pathology occurs quite rarely (in approximately 5 cases out of 1000).

The complication is characterized by the fact that the doctor cannot separate the area of the placenta even with his hands. If the afterbirth does not come out, what should you do in this case? The woman requires urgent surgery. It is performed under anesthesia. During the procedure, the doctor removes the entire uterus and placenta, since there is no other treatment option. Otherwise, the woman may die from excessive blood loss.

Premature detachment of the placenta

During childbirth or immediately after it, such a complication may occur. In this case, the woman experiences severe pain, which resembles a long, endless contraction. If the complication occurs in the first or second stage of labor, the pathology can lead to the death of the baby. The woman also runs the risk of losing a large amount of blood. That is why, in case of premature detachment of the placenta, an emergency procedure is carried out. The only exceptions are those cases when the fetus has already entered the woman’s birth canal.

With premature expulsion of the placenta, a damaged area occurs between the wall of the uterus and the placenta. This leads to blood pooling in the area. With prolonged delay, the liquid can soak through the wall of the reproductive organ and seep into the abdominal cavity. In this case, there is only one way out of this situation - removal of the placenta along with the uterus.

Retention of parts of the placenta in the uterus

Quite a lot of women experience the fact that the placenta does not come out completely. The doctor can detect the pathology at the next examination. Also, the symptoms of the disease are the following: increased body temperature, abdominal pain and severe bleeding.

Correction in this case involves curettage. It is carried out under general conditions or within the walls of a hospital.

How to promote proper separation of the placenta

In order to avoid any complications during childbirth, it is necessary to engage in their prevention during pregnancy. The expectant mother is recommended to lead an active lifestyle (if there is no threat of miscarriage), as well as to eat right. If a woman has any formations in her cavity, then she needs to carefully monitor the attached placenta. During diagnostic ultrasound procedures, the specialist pays attention to where the placenta is located.

Also, after expulsion of the fetus from the reproductive organ, the doctor can massage the walls of the uterus. In this case, its contractile function will increase, and the afterbirth will leave its location faster and easier.

Summarizing

So, now you know what afterbirth is. After birth (a photo of the process is presented in the article), some formations are sent for additional analysis, which is called histology. Most often, it is necessary if the baby died during birth. Also, histology is prescribed to those women in labor whose placenta have neoplasms in the form of cysts, polyps or nodes of an unknown nature.

The placenta is a vital component for the baby while he is in the womb. Every woman in labor should have an idea of what an afterbirth is and when it leaves the female body. Give birth easily and on time. Health to you and your kids!

The path to bringing a child into the world is quite long and labor-intensive. After contractions, pushing and the birth of the baby, the girl also experiences the separation of the placenta. It is very important to ensure that everything goes according to the rules and quickly. If even the smallest particle of the child's place remains in the uterus, further inflammation and deterioration of well-being cannot be avoided.

In order to understand what the afterbirth looks like, you need to understand its structure and pay attention to the functions that are assigned to it. This temporary organ is very important for the baby and mother during pregnancy, and its proper release has a huge impact on the future well-being of the young mother.

The afterbirth is a temporary organ that the embryo needs throughout the entire pregnancy.

It plays a special role in the breathing, nutrition and development of the baby, and also protects the fetus from harmful external factors.

Visually, the child's seat looks like a bag with a membrane attached inside. This membrane performs an important function, as it is the connection between the circulatory system of the baby and the mother.

The system consists of a membrane, placenta and umbilical cord. You should know that everything is formed in the 4th month, and by the 36th week it tends to age. You can talk about how much a given organ weighs based on the situation. If pregnancy is normal and there are no complications, the weight will be 500 g, the size will be from 15 to 20 cm.

The main purpose

This temporary organ performs extremely important functions for the female body and is worth remembering. It takes part in the exchange of oxygen and carbon dioxide, and also removes metabolic products, delivers nutrients and protects the fetus, which develops over 9 months, from damage.

Among the main functions:

protective - the child is reliably protected from maternal antibodies, as well as maternal blood is protected from the penetration of child antigens;
nutritious - the child's place provides the baby with proper nutrition;
exchange - oxygen from the mother's blood is able to enter the baby's blood;
excretory - participates in the transport of metabolites;
endocrine - produces biologically active substances and hormones necessary for mother and child.

Departure

The birth of placenta after childbirth is a very important and significant issue for any woman. It is the third stage during the birth of a child. When the placenta comes out after the fetus, it is necessary to monitor the patient’s condition. At this moment, doctors assess the extent of blood loss, pay attention to the mother’s pulse and blood pressure, and also closely monitor her general condition.

After two hours, the process is completely completed, but after the birth of the placenta, the woman may still feel blood loss for some time - a volume of 220 ml (anything more than normal indicates a violation). It is very appropriate to ensure that there is no bleeding and the placenta is not retained. If the exit stage has slowed down, you cannot do without outside help. Doctors often have to remove it themselves.

If it doesn't work out

It is difficult to say why the placenta does not come out. Medical workers should be attentive and prompt at this moment. Such a complication can lead to an irreversible outcome and even increase the likelihood of death of the young mother.

Expulsion can be done using different methods:

light painless massage combined with muscle tension and pushing (Abuladze method);
without tension on the part of the girl, with impressive pressure and internal movement downwards (Genter method);
the most effective way: light massage, squeezing, pushing (Crede-Lazarevich method).

Such methods can be used not only for complete expulsion, but also to facilitate the process when it is difficult for the mother to cope on her own and requires outside help. There are also cases during which anesthesia and surgery are required.

Signs of exit

There are a number of signals by which one can confidently determine that the process of separation has begun. An experienced doctor should regularly conduct a personal examination and carefully monitor the patient’s condition in order to notice them. You can talk about the removal of a child's place if:

Changes in height, shape and uterine structure occur. It becomes flat, deviates to the right and rises towards the navel - Schroeder's sign.
The end of the umbilical cord, which comes out of the vagina, becomes longer and the umbilical cord itself also lengthens - Alfred's sign.
The woman feels the urge to push. But this does not happen to all mothers - a sign of Mikulic.
Elongation of the umbilical cord after such attempts indicates successful separation from the uterus - Klein's sign.
Pressing with a finger on the suprapubic area provokes elongation of the umbilical cord - the Klyuster-Chukalov sign.

It should be understood that when there is no process of tissue separation, this is natural.

If mommy does not complain about anything and feels normal, she has no bleeding or other signs of abnormalities, there is no reason to panic. Understanding this, doctors can allocate a few more hours (no more than two) while waiting for the process to begin. If such a step does not bring changes or the patient’s condition has worsened significantly, then intervention from medical workers cannot be avoided. Doctors perform surgery under anesthesia or scrape out the cavity manually themselves.

Inspection

Knowing what is done with the placenta after childbirth and where it is disposed of is extremely useful. The first thing doctors do is submit a sample for histological examination. This is done to check the integrity of the placenta. If even a small particle remains inside, there is a risk of complications in the form of an inflammatory process and dangerous uterine bleeding. Medical professionals examine the appearance of the sample: its structure, size, integrity and general condition of the blood vessels. The shell is examined from all sides very carefully; there should be no torn edges or vascular damage.

There are cases when during the examination it is clear that this organ has not completely come out. Such an incident requires medical attention; doctors usually clean the uterus. This manipulation can be carried out manually or using a special spoon - a curette.

If there are membranes left in the uterus, cleaning is not necessary.

The membranes will come out with lochia (special secretions with blood, fragments of the membrane and particles of the child's place).

What do you do with the afterbirth after childbirth? A mandatory step is to weigh the sample and note the studies performed in the patient’s medical record. Next, the placenta is disposed of.

After examining the child's place, the doctor begins to examine the patient herself. It is very important at this stage to assess the volume of blood lost over time, wash the wound surface with a disinfecting solution, and carefully stitch up all cuts and tears. Next, the young mother goes to the ward, where her health is constantly monitored by experienced specialists. Close attention is provided for 3 hours; this first time carries the risk of complications in the form of uterine bleeding due to decreased uterine tone.

Prevention of complications

You can take care of yourself and simplify the process of having a baby place even during pregnancy. Monitoring your well-being at this stage is extremely important and necessary for any girl.

Prevention measures are:

It is necessary to lead a healthy lifestyle.
It is important to monitor your diet, if necessary, limit sweet, fried, fatty, spicy, smoked and salty foods.
If chronic diseases are a concern, it is necessary to cure them and bring the indicators back to normal.
It is recommended to allocate the proper amount of time for rest and sleep; you need to sleep at least 8-9 hours at night.
It is forbidden to overload the body with intense physical activity.
It is important to avoid crowds and places with large numbers of people.
It is recommended to worry and worry less and avoid the slightest stress.
Any diets, fasting and severe dietary restrictions are contraindicated.
It is recommended to take a complex of vitamins, fish oil and preparations containing iron.

Such measures significantly improve a woman’s overall well-being, and also reduce the likelihood of possible risks in the future.

Some expectant mothers are so concerned about the birth of a baby that they think through literally every nuance: they choose a maternity hospital, an obstetrician-gynecologist, a good ward, collect things that will be needed directly in the hospital... All this so that the birth of a child becomes a pleasant event, and not a nightmare memory.

But few women in labor are concerned about what happens after childbirth to a unique organ called placenta. And it’s completely in vain... Doctors casually slip many women a document to sign that obliges them to give placenta for medical research.

Indeed, in good maternity hospitals, the placenta is first sent for histological examination and then disposed of. But this does not happen in all medical institutions. Each city and maternity hospital has its own laws.

Placenta after birth

The placenta can be sold or even resold for the production of expensive medical and cosmetic products. Therefore, our kids cut the umbilical cord immediately after birth... To preserve the “freshness” of the placenta.

Doing this is strictly prohibited! The thing is that immediately at the moment of birth the baby is in double breathing: first of all, he receives oxygen through the umbilical cord and breathes a little through the lungs.

And doctors cut the umbilical cord immediately after birth, as a result of which the baby does not receive oxygen through the umbilical cord and feels suffocated... At this moment, the child has to take sharp breaths to activate the lungs. It hurts him terribly!

In addition, if the umbilical cord is cut immediately, the baby is deliberately deprived of placental blood, which contains natural protective immunity. You may ask why they do this? And so that in the future medicine can sell the parents of this child expensive vaccinations, pills, medicines and ointments! Nothing personal - just business.

In order not to become a hostage to domestic medicine, we need to discuss in detail birth process with a personal obstetrician-gynecologist. Also, if possible, it is better to take the placenta home after childbirth and dispose of it yourself.

The placenta is a unique and very important organ that exists only during pregnancy. The placenta is often called a child’s place, because it connects the baby with the mother’s body, providing the baby with the necessary nutrients. Once the fetus has exited the woman's womb during childbirth, the final third stage begins when the placenta leaves. It includes not only the placenta itself, but also the membranes and the umbilical cord. The process usually takes no more than half an hour and is accompanied by a sharp contraction of the uterus and bleeding.

Birth of placenta

Things don't always happen as expected. In some cases, uterine contractions do not lead to anything, then doctors ask the woman in labor to perform actions to facilitate the separation of the placenta:

pull the nipples or massage them; irritation of the nipples reflexively increases contractions of the uterine muscles;
attach the baby to the breast;
raise the pelvis and rotate it, leaning on your hands and feet - to speed up blood circulation in the uterus;
breathe deeply into your stomach and chest at the same time, this will help the anterior abdominal wall to make intense movements.

If the placenta has not separated naturally, one of the methods of manually releasing the placenta is used:

Ambuladze's method. After emptying the bladder, the obstetrician grasps the abdominal wall with his hands so that the two rectus abdominis muscles are tightly grasped with his fingers. Then the woman in labor needs to push. In most cases, the placenta comes out easily after childbirth due to a significant reduction in the volume of the abdomen and elimination of the divergence of the rectus muscles.
Crede-Lazarevich method. Used when there is no effect from the previous method. The doctor moves the uterus to the middle, then massages the fundus of the uterus in a circle to induce contractions. It is important to simultaneously press on the uterus with the entire surface of the hand (palm from top to bottom and fingers from front to back).
Genter's method. Squeezing out the placenta after childbirth using bilateral pressure with fists. The pressure on the uterus gradually increases, directed downward and inward. This method is quite traumatic, so it is used with great caution.

Consequences of manual separation of the placenta during the normal third stage of labor:

disruption of the physiological process of placental abruption;
change in the rhythm of contractions;
strangulation of the placenta;
retention of separated placenta due to uterine spasm;
increased bleeding.

Placental abruption during childbirth should occur only after the baby is born. If this happens earlier, the fetus may die as a result of oxygen starvation. Premature placental abruption is an indication for emergency cesarean section.

What does the placenta look like after childbirth?

A normal mature one is on average 3-4 cm, with a diameter of up to 18 cm. Most often, it is larger than parents expected. The baby's place after childbirth is uneven from the side of its attachment to the uterus. On the other side it is shiny and smooth with an umbilical cord in the middle. The afterbirth looks like a large piece of liver.

Evaluation and inspection of the placenta

The birth placenta is carefully examined by the obstetrician. To do this, it is laid out on a flat surface, then the absence or presence of violations is identified, and the integrity of the tissue is checked. When examining the placenta, pay special attention pay attention to its edges, since pieces of tissue are more often torn off in the peripheral sections. The surface should be smooth and bluish-gray in color. If a broken blood vessel is detected, we can talk about the presence of tissue remaining in the uterus. In this case, the uterine cavity is checked manually and the separated portion of the placenta is removed. Defects of the placenta are areas of fatty degeneration, calcification, and old blood clots. It is imperative to determine whether all the membranes have been born and the location of the rupture of the membranes. If necessary, a laboratory analysis of the placenta is performed. All data is recorded in the birth history.