Module 4 PPB 3rd Stage placental separation and coagulation
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17 Terms
Q: When does placental separation occur?
A: During the third stage of labour after the birth of the baby.
Q: What causes placental separation?
A: Strong uterine contractions and retraction of the uterine muscle.
Q: What is uterine retraction and how does it aid placental separation?
A: Permanent shortening of uterine muscle fibres, which reduces uterine size and helps detach the placenta.
Q: What happens at the placental site during separation?
A: A small haemorrhage occurs as the placenta detaches from the uterine wall.
Q: What role do uterine contractions play in placental separation?
A: They continue after birth to help shear the placenta away from the uterine wall.
Q: How does breastfeeding influence placental separation?
A: Nipple stimulation releases oxytocin, increasing uterine contractions to aid separation.
Q: What are "living ligatures"?
A: Contracting uterine muscle fibres that compress blood vessels to reduce bleeding.
Q: How do living ligatures reduce blood loss?
A: They constrict uterine blood vessels by squeezing them during contraction and retraction.
Q: What is the role of uterine pressure in controlling bleeding?
A: The uterine walls press against the placental site after separation to limit blood loss.
Q: Why is coagulation important during placental separation?
A: To prevent excessive blood loss from the placental site.
Q: What happens to coagulation activity during and after labour?
A: It increases (hypercoagulable state).
Q: What is thromboplastin and what is its role?
A: A substance that converts prothrombin to thrombin, promoting clot formation.
Q: What happens to fibrinolytic activity during this time?
A: It decreases, allowing clots to remain stable.
Q: What forms at the placental site after separation?
A: A fibrin mesh that helps stop bleeding.
Q: How quickly does clotting begin after placental separation?
A: Almost immediately.
Q: How do uterine contractions and coagulation work together to prevent haemorrhage?
A: Contractions compress blood vessels while coagulation forms clots, together minimising blood loss.
Q: Why is the puerperium considered a hypercoagulable state?
A: Because clotting factors are increased and fibrinolysis is reduced to prevent postpartum haemorrhage.
