Placental Cord Drainage versus no Placental Drainage in the Management of Third Stage of Labour: Randomized controlled trial

摘要

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.