The instrument used to remove the placenta, as indicated in the provided reference, is the Bierer forceps.
While the Bierer forceps is an instrument used for placental removal, it's important to understand that several methods and instruments may be employed depending on the circumstances of the delivery. In many routine vaginal deliveries, manual placental delivery (without instruments) is the norm. However, when complications arise, or assistance is required, instruments like the Bierer forceps can be beneficial.
Here's a breakdown of placental removal methods:
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Manual Placental Removal: This is the most common method. After the baby is delivered, the doctor or midwife waits for signs that the placenta has separated from the uterine wall. These signs include a gush of blood and lengthening of the umbilical cord. The placenta is then delivered by gentle traction on the umbilical cord combined with suprapubic pressure (pressure on the mother's abdomen above the pubic bone).
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Instrumental Placental Removal (using Bierer Forceps): In cases where the placenta doesn't detach naturally, or there is retained placental tissue, instruments like Bierer forceps might be used. Bierer forceps are specifically designed to grasp and remove placental tissue. These are used cautiously to avoid uterine perforation or injury.
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Other Instruments (Less Common): In rare situations, other instruments like curettes may be used to remove retained placental fragments, particularly after a miscarriage or incomplete abortion. However, these are used with extreme care to avoid damaging the uterine lining.
Important Considerations:
- Skill and Experience: Placental removal requires skilled and experienced healthcare providers.
- Risk of Complications: All methods of placental removal carry a risk of complications, including hemorrhage, infection, and uterine damage. The use of instruments increases these risks slightly.
- Individualized Approach: The best method for placental removal depends on the individual patient, the circumstances of the delivery, and the skill of the healthcare provider.
Therefore, while the Bierer forceps can be used, it is important to recognize that placental removal is not always done instrumentally.
