Placental Cord Drainage versus No Placental Drainage in the Management of Third Stage of Labour : Randomized Controlled Trial

Abstract

Back ground:the third stage of labour begins immediately after the birth of the baby and ends with the expulsion of the placenta and fetal membranes.It is preceded by contraction and retraction of the uterus to reduce uterine size and expel the placenta with minimal haemorrhage. Placental cord drainage involves clamping and cutting of the umbilical cord after the birth of a baby and then, immediately unclamping the maternal side of the cord so the blood can drain freely into a container. Aim of the work:the aim of this study is to assess the effect of placental cord drainage during active management of the third stage of labour on reducing both blood loss and the length of the third stage. Materials and Methods:a randomized controlled trial was carried out on180 patients who underwent vaginal delivery at Ain Shams University Maternity Hospital labour ward.Population of this study were randomly assigned to either:Group A: 90 patients was the study group(cord drainage).Group B: 90 patients was the control group(no cord drainage). Moreover,the duration of third stage was compared as the primary outcome. The incidence of postpartum hemorrhage, retained placenta, manual removal of placenta, and the need for blood transfusion were compared. Results:the duration and amount of blood loss of third stage of labour was significantly lower in study group than control group.Furthermore,the Postoperative pulse rate,Systolic Blood Pressure, Diastolic Blood Pressure,Hemoglobin and hematocrit value were significantly higher in study group than control group. The retained placenta (manual removal),Postpartum hemorrhageand Blood transfusion were non-significantly less frequent among study group than among control group. Conclusion:active management of the third stage of labour with the cord drainage method significantly reduced postpartum hemorrhage and the duration of the third stage.

Effect of Placental Cord Drainage on the Third Stage of Labour Progress and Incidence of Postpartum Hemorrhage: Randomized Controlled Clinical Trial

“…The current study results revealed that there were significant differences were observed between the PCD and control group in relation to the manual removal of placenta, need for blood transfusion, and uterine condition during postpartum period. These findings are partially in the same line with the previously mentioned studies conducted by Mithala et al, [23] and Mohamed et al, [24] they reported that the retained placenta was less frequent among PCD group than control. They further added that the need for postpartum blood transfusion was lower in PCD group compared to control without significant differences.…”

“…The present study revealed that there were significant difference between both groups regarding postpartum systolic BP, diastolic BP and pulse. This result is congruent with the previously mentioned study conducted by Mohamed et al, [24]. They concluded that the postpartum systolic blood pressure, diastolic blood pressure and pulse were affected among PCD group compared to control.…”

“…The third stage duration among their participants was 2.28 minutes shorter than the control group. In addition, the previously discussed Mohamed A 2017 [24] is online with the present study finding. They reported that the 3 rd stage duration was 4.4 minute in PCD group compared to 7.7 minute in the control group.…”

“…They concluded that PCD could reduce 3 rd stage duration and consequently reduced the amount of blood loss. Third, Mohamed et al, [24] who had conducted randomized controlled trial on180 women who underwent normal vaginal delivery. They compared the PCD with no PCD on the 3 rd stage progress.…”

A study of placental blood drainage in third stage of labour to prevent postpartum haemorrhage: a randomized controlled study

“…They reported significance difference in postpartum haemoglobin level in placental cord drainage group than control group. 6,9,[12][13][14] There were certain limitations in our study. Sample size being 50 in study group so the results cannot be generalised.…”