The marginal separation of the placenta is known as:

Appeared in: DSSSB 13 August 2024

Explanation

The Matthews Duncan method describes the marginal separation of the placenta, where detachment begins at the placental edges.
In this mechanism, blood from the placental site escapes from the uterus immediately, leading to visible, continuous bleeding.
The rough, dull, dark-red maternal surface of the placenta is the first to appear at the introitus.
This method is less common than the Schultze method, occurring in about 20% of deliveries, and is associated with a higher risk of retained placental fragments.

Option A: McRobert's method is an obstetric maneuver used to manage shoulder dystocia, a complication during fetal delivery.
Option B: The Schultze method describes central, not marginal, separation of the placenta. It is characterized by the fetal side ('Shiny Schultze') presenting first.
Option C: The Burns-Marshall technique is a specific maneuver for delivering the aftercoming head in a breech presentation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Mechanisms of placental separation during the third stage of labor as background academic context rather than a clinical decision trigger.
Recognizing the mechanism of placental separation is crucial for managing the third stage of labor and anticipating potential complications.
The Matthews Duncan method is associated with a higher risk of incomplete placental separation and postpartum hemorrhage (PPH) because the separation process can be less efficient, potentially leaving fragments attached to the uterine wall.
Nurses must carefully inspect the delivered placenta for completeness, regardless of the separation mechanism, but with increased vigilance after a Duncan separation.

How to Approach the Question

First, identify the key phrase in the question: 'marginal separation of the placenta'.
Recall the two primary mechanisms of placental separation that occur during the third stage of labor.
Associate the 'Matthews Duncan' method with marginal separation, where the dull, rough maternal surface ('Dirty Duncan') presents first.
Associate the 'Schultze' method with central separation, where the shiny fetal surface ('Shiny Schultze') presents first.
Eliminate the other options, recognizing that McRobert's method is for shoulder dystocia and the Burns-Marshall technique is for breech delivery.
Select the option that correctly names the mechanism for marginal separation.

Concept Tested & Keywords

Concept Tested: Mechanisms of placental separation during the third stage of labor.
Stem keywords: marginal separation, placenta
Lead-in keywords: known as
Negative lead-in flag: false

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Practise the full DSSSB 13 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.