13. A 25-year-old woman delivered her baby at a health center. You attempt to deliver the placenta actively with intramusculal oxytocin but it was not successful. She starts to bleed heavily. It has been 40 minute since the delivery of the baby . Despite your attempt, the placenta neither expels out nor it shows sign of separation. What is your best intervention at this level? ( Hidar 2012/December 2019) A. Put her on IV fluid, give ampicilline 2 g IV refer her B. Change oxytocin with ergometrine and attempt CCT once again C. Wait the placenta for additional 20 minutes, attempt manual removal D. Give sedative agent and prophylactic antibiotics, attempt manual removal

Question

13. A 25-year-old woman delivered her baby at a health center. You attempt to deliver the placenta actively with intramusculal oxytocin but it was not successful. She starts to bleed heavily. It has been 40 minute since the delivery of the baby . Despite your attempt, the placenta neither expels out nor it shows sign of separation. What is your best intervention at this level? ( Hidar 2012/December 2019) A. Put her on IV fluid, give ampicilline 2 g IV refer her B. Change oxytocin with ergometrine and attempt CCT once again C. Wait the placenta for additional 20 minutes, attempt manual removal D. Give sedative agent and prophylactic antibiotics, attempt manual removal

Answer 1

The correct answer is C. Wait the placenta for additional 20 minutes, attempt manual removal.In this scenario, the woman is experiencing heavy bleeding and the placenta is not separating or being expelled despite attempts with oxytocin. The best intervention at this level would be to wait for an additional 20 minutes to see if the placenta will naturally separate and then attempt manual removal if it does not.Manual removal of the placenta, also known as "managed third stage of labor," is a procedure where the healthcare provider manually removes the placenta from the uterus. This is typically done when the placenta is not separating on its own or with medical intervention.Option A is not the best choice because giving ampicillin and referring the patient is not the appropriate intervention for heavy bleeding and retained placenta. Option B is not the best choice because changing oxytocin with ergometrine and attempting CCT once again may not be effective in this situation. Option D is not the best choice because giving a sedative agent and prophylactic antibiotics is not the appropriate intervention for heavy bleeding and retained placenta.

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