Placenta expulsion occurs in which stage?

Appeared in: BSF Staff Nurse - 2021

Explanation

The third stage of labor is defined as the period from the birth of the baby until the placenta and membranes are completely delivered.
This stage is also referred to as the 'placental stage'.
Strong uterine contractions continue after the baby's birth, causing the placenta to detach from the uterine wall.
The duration is typically about 5 to 15 minutes but can last up to 30 minutes. Active management significantly shortens this duration.

Option A: The first stage of labor is characterized by the onset of regular contractions leading to the progressive dilation and effacement of the cervix. It ends when the cervix is fully dilated to 10 cm, not with the expulsion of the placenta.
Option B: The second stage of labor, also known as the 'pushing stage', begins with full cervical dilation and ends with the birth of the baby. The placenta is still in the uterus during this stage.
Option D: The fourth stage of labor is the immediate postpartum period, typically the first 1 to 4 hours after the delivery of the placenta. It is a critical time for monitoring the mother for complications like hemorrhage as her body begins to recover.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of the different stages of labor and their defining events as background academic context rather than a clinical decision trigger.
Proper management of the third stage of labor is critical for preventing postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide.
Nurses play a vital role in the third stage by administering uterotonic medications (like oxytocin), assessing for signs of placental separation, performing controlled cord traction, and massaging the uterine fundus to ensure it is well-contracted.
What if? If the placenta is not expelled within 30 minutes of the baby's birth, it is considered a 'retained placenta'. This is a medical emergency that requires intervention, such as manual removal, to prevent severe bleeding and infection.

How to Approach the Question

First, identify the key term in the question, which is 'placenta expulsion'.
Next, recall the sequence and defining characteristics of the four stages of labor.
The first stage involves cervical dilation.
The second stage involves the birth of the baby.
The third stage involves the delivery of the placenta.
The fourth stage is the recovery period.

Concept Tested & Keywords

Concept Tested: The question tests the knowledge of the different stages of labor and their defining events.
Stem keywords: Placenta expulsion, stage, labor
Lead-in keywords: which stage

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E6 Physiology Guyton 4SAE Part 3 p. 67-69

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 49-57

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