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Retained placenta — DRCOG MCQ

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ModerateLabourRetained placentaDRCOG

A 26-year-old woman has a vaginal birth with active management of the third stage. Thirty-five minutes later the placenta has not delivered and bleeding is increasing. She feels faint. What is the most appropriate management?

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Correct answer: A — Call for obstetric help and prepare for manual removal

A retained placenta with increasing bleeding requires urgent obstetric management and preparation for manual removal, alongside haemorrhage measures. Waiting several hours is unsafe when bleeding is increasing. Breastfeeding can support uterine contraction but is not adequate management of haemorrhage. Discharge or routine review would be dangerous.

Reference: RCOG Green-top Guideline No. 52; NICE NG235