Controlled cord traction for the third stage of labour

Mshweshwe, Nolundi; Hofmeyr, G Justus; Gülmezoglu, A. Metin

doi:10.1002/14651858.cd008020

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…We indentifi ed one review 20 at protocol stage and one pilot randomised trial, 13 which included 200 women and suggested a potential protective eff ect of controlled cord traction on blood loss. The date of the last search was Feb 7, 2012.…”

Section: Systematic Reviewmentioning

confidence: 99%

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Gülmezoglu¹,

Lumbiganon²,

Landoulsi³

et al. 2012

The Lancet

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Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial. Lancet, 379 (9827 A Metin Gülmezoglu, Pisake Lumbiganon, Sihem Landoulsi, Mariana Widmer, Hany Abdel-Aleem, Mario Festin, Guillermo Carroli, Zahida Qureshi, João Paulo Souza, Eduardo Bergel, Gilda Piaggio, Shivaprasad S Goudar, John Yeh, Deborah Armbruster, Mandisa Singata, Cristina Pelaez-Crisologo, Fernando Althabe, Peter Sekweyama, Justus Hofmeyr, Mary-Ellen Stanton, Richard Derman, Diana Elbourne SummaryBackground Active management of the third stage of labour reduces the risk of post-partum haemorrhage. We aimed to assess whether controlled cord traction can be omitted from active management of this stage without increasing the risk of severe haemorrhage.

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Section: Systematic Reviewmentioning

confidence: 99%

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Gülmezoglu¹,

Lumbiganon²,

Landoulsi³

et al. 2012

The Lancet

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124

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“…Much of this reduction is due to the prophylactic uterotonic drug: [ 6 , 7 ] oxytocin is the drug of choice, as it has comparable impact on blood loss with fewer adverse effects than ergot alkoids [ 6 ]. The impact of other components, such as when is best to give the uterotonic [ 8 ], when to clamp the cord [ 9 ] and whether to use controlled cord traction [ 10 ], is unclear. Although there is no clear consensus about the components of active management of the third stage of labour [ 4 , 11 ], the current World Health Organisation (WHO) recommendation is that it should include administration of a uterotonic (oxytocin, if it is available) soon after birth of the baby, delayed cord clamping, and delivery of the placenta by controlled cord traction [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Policies for care during the third stage of labour: a survey of maternity units in Syria

Matar

Almerie

Alsabbagh

et al. 2010

BMC Pregnancy Childbirth

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BackgroundCare for women during the third stage aims to reduce the risk of major haemorrhage, but is very variable. The current World Health Organisation (WHO) recommendation is that care should include administration of a uterotonic (oxytocin, if it is available) soon after birth of the baby, delayed cord clamping, and delivery of the placenta by controlled cord traction.MethodsTo ascertain care policies used during the third stage of labour in maternity units in Syria, we conducted a survey of 69 maternity units in obstetric and general public hospitals. A brief questionnaire was administered by face to face interview or telephone with senior obstetricians and midwives. Outcome measures were the use of prophylactic uterotonic drugs, timing of cord clamping, use of controlled cord traction, and treatment for postpartum haemorrhage. Obstetricians were asked about both vaginal and caesarean births, midwives only about vaginal births.ResultsResponses were obtained for 66 (96%) hospitals: a midwife and an obstetrician were interviewed in 40; an obstetrician only in 20; a midwife only in 6. Responses were similar, although midwives were more likely to report that the umbilical cord was clamped after 1-3 minutes or after cessation of pulsation (2/40 obstetricians and 9/40 midwives). Responses have therefore been combined.One hospital reported never using a prophylactic uterotonic drug. The uterotonic was Syntometrine® (oxytocin and ergometrine) in two thirds of hospitals; given after delivery of the placenta in 60 (91%) for vaginal births, and in 47 (78%) for caesarean births. Cord clamping was within 20 seconds at 42 hospitals 64%) for vaginal births and 45 (75%) for caesarean births. Controlled cord traction was never used in a quarter (17/66) of hospitals for vaginal births and a half (32/60) for caesarean births.68% of respondents (45/66) thought there was a need for more randomised trials of interventions during the third stage of labour.ConclusionMost maternity units report using Syntometrine®, usually given after delivery of the placenta, clamping the cord within 20 seconds, and using controlled cord traction.

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Active versus expectant management for women in the third stage of labour

Begley

Gyte

Devane

et al. 2015

Cochrane Database of Systematic Reviews

203

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Although there is a lack of high-quality evidence, active management of the third stage reduced the risk of haemorrhage greater than 1000 mL at the time of birth in a population of women at mixed risk of excessive bleeding, but adverse effects were identified. Women should be given information on the benefits and harms of both methods to support informed choice. Given the concerns about early cord clamping and the potential adverse effects of some uterotonics, it is critical now to look at the individual components of third-stage management. Data are also required from low-income countries.

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Controlled cord traction for the third stage of labour

Cited by 3 publications

References 12 publications

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Policies for care during the third stage of labour: a survey of maternity units in Syria

Active versus expectant management for women in the third stage of labour

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