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Third stage – begins
as soon as baby delivered and lasts until placenta delivered. Combination of
contractions and involution (growing smaller) . Placenta detaches from wall within 10 – 15
mins → inc bleeding; delivery of placenta follows. Classic signs:
uterus “rounds up” into ball, moves upward, the cord lengthens, followed by
rush of vaginal blood. Once placenta delivered, contractions close off
arterioles, uterus continues to shrink, & bleeding ↓.
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Figure 15-14, p 326: “shiny”
Shultze or “Dirty” Duncan
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Fourth stage –
“recovery stage” or 1st 4 hours /p delivery. Avg blood loss is 250
– 500ml;blood is redistributed in venous bed, → mod drop in BP, inc
pulse pressure, and mod tachycardia. fundus is midline,
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