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Recently presented at the RCOG Congress in Cape Town and now published in the European Journal of Obstetrics and Gyneacology, a midwifery-anaesthetic-obstetric team present a new technique for the delivery of a retained placenta.
Retained placenta is important as the incidence ranges from 0.1% to 3.3% with maternal deaths reported as high as 10%. We show in our observational study that the Windmill technique developed at the Charité University Hospital in Berlin, reduced the need for invasive manual removal of placenta by 86% in patients with retained placenta. There were reductions in mean blood loss, time to delivery of the placenta, antibiotic prophylaxis and use of general anesthesia. Importantly, mothers stayed with their babies.
The Windmill technique for the delivery of the retained placenta is a simple, safe, effective and easy to teach technique that reduces invasive operative manual removal of the placenta, postpartum blood loss and delay in the placenta delivery. This innovative technique can also be a lifesaving intervention especially in areas with limited or no access to operative facilities.
See the video demonstration below as well as a description of the principles and theory of the technique with a slide presentation.
For further information Email : Larry.Hinkson@charite.de
For further information Email : Larry.Hinkson@charite.de
Windmill Technique oral presentation at the RCOG 2017 Congress in Cape Town South Africa
rcog oral presentation.pdfWindmillvideo.m4v
Theory of the Windmill Technique
Theory of the Windmill Technique
The Windmill technique of placenta delivery involves continuous gentle traction on the umbilical cord in a plane perpendicular to the line of the birth canal in a centripetal motion at the level of the introitus, similar to the movement of the sails of a windmill. The principle behind this technique is based on the physics of 3 dimensional vector forces. Forces are described as a vector with magnitude, direction and a point of application. Any force can be described as having component vector forces in two or three-dimensional planes. Therefore, with the rotational application of constant cord traction regardless of where the placenta is located, there is always a point at which, during the range of movement of the traction force, a component thereof will come to be applied intermittently to the placenta bed and result in placenta separation. Evidence of effective placenta release is observed by lengthening of the umbilical cord. Counter traction is applied to the uterus in the traditional fashion. The procedure should be abandoned if there is no lengthening of the cord, cord rupture or postpartum bleeding. From our experience the mean duration of the maneuver is 7 minutes. A video demonstration is shown above.
The Windmill technique of placenta delivery involves continuous gentle traction on the umbilical cord in a plane perpendicular to the line of the birth canal in a centripetal motion at the level of the introitus, similar to the movement of the sails of a windmill. The principle behind this technique is based on the physics of 3 dimensional vector forces. Forces are described as a vector with magnitude, direction and a point of application. Any force can be described as having component vector forces in two or three-dimensional planes. Therefore, with the rotational application of constant cord traction regardless of where the placenta is located, there is always a point at which, during the range of movement of the traction force, a component thereof will come to be applied intermittently to the placenta bed and result in placenta separation. Evidence of effective placenta release is observed by lengthening of the umbilical cord. Counter traction is applied to the uterus in the traditional fashion. The procedure should be abandoned if there is no lengthening of the cord, cord rupture or postpartum bleeding. From our experience the mean duration of the maneuver is 7 minutes. A video demonstration is shown above.
korWindmillrcog2017for the web.pptxGoogle Sites
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