Third Stage Labour practice

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Any stageFoundations71Mechanisms of disease35Clinical rotations832Pre-internship488

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Obstetrics and Gynaecologycommon

Thirty-five minutes after a vaginal birth, the placenta has not separated and the woman has lost 900 mL of blood. The uterus is firm, the placenta is palpable at the cervical os and her haemodynamic state is currently stable. There is no suggestion of placenta accreta in the antenatal records. Which one of the following is the most appropriate next step?