If the placenta is not delivered within 30 minutes of delivery of the baby, it is called

NHM UP Staff Nurse-2021 Shift-2nd

Obstetrics & Gynaecology

Easy

Appeared in: NHM UP Staff Nurse-2021 Shift-2nd

Explanation

Retained placenta is the correct medical term for the failure of the placenta to be expelled within a specified time after childbirth.
The standard clinical definition for retained placenta is when the third stage of labor exceeds 30 minutes.
This condition occurs when there is an interruption in the normal physiological process of placental separation and expulsion.
It is a significant obstetric complication primarily because it is a major risk factor for postpartum hemorrhage (PPH).

Option A: Placenta praevia is an abnormal implantation of the placenta in the lower uterine segment, which typically causes bleeding before or during labor (antepartum hemorrhage), not a delay in placental delivery after birth.
Option B: Postpartum hemorrhage (PPH) is defined by the volume of blood loss after delivery, not the timing of placental expulsion. While retained placenta is a primary cause of PPH (under the 'Tissue' category of the 4 T's), it is the cause, not the definition itself.
Option D: Placental ischemia refers to reduced blood flow to the placenta during pregnancy. It is a chronic condition associated with complications like preeclampsia and fetal growth restriction, not an acute event after delivery.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Definition and timeframe of retained placenta as a complication of the third stage of labor as background academic context rather than a clinical decision trigger.
Retained placenta is a medical emergency because it is a leading cause of primary postpartum hemorrhage (PPH), which in turn is a major cause of maternal mortality worldwide.
Nurses must closely monitor the third stage of labor, noting the time of the baby's birth and watching for signs of placental separation (e.g., a gush of blood, lengthening of the cord, uterus becoming firm and globular).
If a placenta is retained, nursing interventions include establishing IV access, preparing uterotonic medications (like oxytocin), and readying equipment for a potential manual removal of the placenta by the provider.

How to Approach the Question

This is a factual recall question that tests your knowledge of obstetric terminology and definitions.
First, identify the key information in the question stem: 'placenta not delivered' and the specific timeframe 'within 30 minutes'.
Next, recall the definitions of the four options provided.
Placenta praevia and placental ischemia are complications that occur during pregnancy, not after delivery, so they can be eliminated.
Differentiate between 'Retained placenta' and 'Post partum haemorrhage'. PPH is about blood loss, whereas retained placenta is about the failure of expulsion.
Match the question's description to the correct definition. The failure of the placenta to deliver within 30 minutes is the textbook definition of a retained placenta.

Concept Tested & Keywords

Concept Tested: Definition and timeframe of retained placenta as a complication of the third stage of labor.
Stem keywords: placenta, not delivered, 30 minutes, delivery of the baby
Lead-in keywords: is called

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E6 Obstetrics Williams pp. 13-28, 12-27

E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 268-270