Practice Quiz

CNM Certified Nurse Midwife

Category - Intrapartum

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A nurse midwife notes that the separation of placenta from the uterus via the Schultze mechanism. This means that:
  1. The margin of the placenta separated first; the red, dull and rough surface emerges from the vagina first.
  2. The margin of the placenta separated first; the shiny surface emerges from the vagina first.
  3. The center portion of the placenta separated first; the maternal surface emerges from the vagina first.
  4. The center portion of the placenta separated first; the fetal surface emerges first from the vagina.
Explanation
Answer: D - The Schultze mechanism indicates that the placenta’s center portion separated first from the uterus and that the fetal surface emerges first from the vagina. The fetal surface is smooth and shiny, whereas the maternal surface appears dull red and feels rough. The placenta separates from the uterus via one of two mechanisms: the Schultze mechanism and the Duncan mechanism. The Duncan mechanism indicates that the margin of the placenta separated first from the lining of the uterus and that the maternal surface emerges from the vagina first.
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