A 26-year-old primigravida has an uneventful second stage. After delivery of the baby, the cord is clamped and cut. At 30 minutes, the placenta is not delivered. There is minimal bleeding. On examination, the uterus is contracted. What is the definitive management?
- A Controlled cord traction with fundal pressure
- B Manual removal of placenta under anesthesia ✓
- C Intraumbilical injection of oxytocin
- D Ergometrine 0.2 mg IV
Correct answer: B. Manual removal of placenta under anesthesia
Explanation
Retained placenta is diagnosed when the placenta is not delivered within 30 minutes of birth. Definitive management is manual removal of the placenta under anesthesia. Controlled cord traction is used before 30 minutes in active management. Intraumbilical oxytocin is a temporizing measure but manual removal is definitive.
Reference: Dutta's Textbook of Obstetrics, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.