A 24-year-old woman underwent a normal vaginal delivery of a term infant. After the delivery, the placenta does not deliver even after 30 minutes. Which of the following would be the next step for this patient
After 30 minutes, the placenta is abnormally retained, and a manual extraction is generally attempted. Waiting for another 30 minutes may lead to maternal hemorrhage, which may then lead to an indication for a hysterectomy. However, a hysterectomy would not be the initial step after 30 minutes have passed during the third stage of labor. Oxytocin should not be administered until the placenta has been delivered and the uterine fundus (when inveed) is placed back to its normal location. Oxytocin is a uterotonic agent that aids in allowing the uterus to contract down on itself in an effo to stop bleeding after the placenta has been removed.
Wait for an additional 30 minutes
Attempt a manual extraction of the placenta
Initiate oxytocin
Hysterectomy
Reproductive physiology and hormones in females