Alumbramiento/ Periodos del alumbramiento/ Manejo del alumbramiento 2021😍❗❗

Introduction to Alumbramiento

In this section, we will discuss the different stages of labor and focus on the third stage called "alumbramiento," which is the separation and expulsion of the placenta.

The Four Phases of Alumbramiento

• The first phase is the detachment of the placenta from its insertion point.

• The second phase is the detachment of the membranes.

• The third phase involves the descent of the placenta.

• The fourth phase is the expulsion of the placenta.

Desprendimiento de la Placenta (Detachment of Placenta)

• After childbirth, contractions help decrease the size and volume of the uterus, facilitating detachment.

• Contractions during alumbramiento are painless but aid in detaching the placenta.

• Rupture of blood vessels leads to a hematoma formation, causing gravity and weight to assist in placental descent.

• Two mechanisms for detachment are Schultze mechanism (80% cases) and Duncan mechanism (20% cases).

Desprendimiento de las Membranas (Detachment of Membranes)

• Similar to detachment in placenta, membranes also detach during alumbramiento.

Descenso de la Placenta (Descent of Placenta)

• Contractions and gravity aid in descending the placenta.

• In Schultze mechanism, descent occurs centrally, while in Duncan mechanism, it starts laterally.

Expulsión de la Placenta (Expulsion of Placenta)

• Two types of expulsion: spontaneous and natural.

• In spontaneous expulsion, the placenta is completely eliminated from the birth canal due to contractions and gravity.

• In natural expulsion, the placenta may remain in the vagina and require assistance for removal.

Manejo del Alumbramiento (Management of Alumbramiento)

• Expectant management allows spontaneous detachment and expulsion without medical intervention.

• Active management involves medical assistance to facilitate detachment and expulsion, reducing the risk of postpartum hemorrhage.

• Oxytocin is administered prophylactically, signs of placental detachment are monitored, and gentle traction is applied to the umbilical cord.

The transcript provided does not mention any specific timestamps for some sections.