How Can Methods of Placental Delivery Affect the Amount of Blood Loss During Cesarean Section?
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 288
- 试验地点
- 1
- 主要终点
- blood loss assessment after placental delivery
研究概览
简要总结
To compare between the effect of controlled cord traction and manual removal of the placenta on blood loss among women undergoing caesarean sections
详细描述
Cesarean section (CS) is one of the most commonly performed major abdominal operations in women worldwide and its rate is increasing dramatically every year.
Some of the reported short-term morbidities include hemorrhage, postoperative fever and endometritis. The method of delivering the placenta is one procedure that may contribute to an increase or decrease in the morbidity of CS.
On an average 0.5-1 liter of blood is lost during CS, many variable techniques have been tried to reduce this blood loss. Such techniques include finger splitting versus scissor cutting of incision, in situ stitching verses exteriorization and stitching of uterus , and finally spontaneous or manual removal of the placenta.
Two common methods used to deliver the placenta at CS are cord traction and manual removal.
Manual removal of the placenta which the obstetrician introduce his hand into the uterine cavity to cleave the placenta from the decidua basalis as soon as possible after the delivery of the infant and controlled cord traction in which the obstetrician do external uterine massage and gentle traction on the exposed umbilical cord to facilitate placental delivery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 35 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •All informed and consented women undergoing elective or emergency CS will be legible for enrollment into the study
排除标准
- •Multiple gestation.
- •Pregnancy below 34 weeks.
- •Severe maternal anemia.
- •Severe pre-eclampsia
- •Prolonged labor.
- •Prolonged rupture of the membranes with fever.
- •Placental abruption.
- •Placenta previa.
- •Placenta accreta.
- •Clotting disorders.
- •Current or previous history of a significant disease including heart disease, liver, renal disorders.
研究组 & 干预措施
manual removal group
Group will be assigned for manual removal of the placenta as the surgeon will introduce his hand into the uterine cavity to cleave the placenta from the decidua basalis as soon as possible after the delivery of the baby by caesarean section
干预措施: manual removal (Procedure)
cord traction group
Group will be assigned for controlled cord traction as the surgeon do external uterine massage and gentle traction on the exposed umbilical cord to facilitate placental delivery after the delivery of the baby by caesarean section
干预措施: cord traction (Procedure)
结局指标
主要结局
blood loss assessment after placental delivery
时间窗: 12 hours
Determine estimated blood loss after placental delivery either by cord traction or manually during caesarean section through comparing pre and postoperative hemoglobin and haematocrit measurements
次要结局
- Placental delivery time.(30 minutes)
- Need of blood transfusion(12 hours)
- Need to use ecbolics(30 minutes)
- Duration of operation(2 hours)
- Blood loss > 1000 ml(12 hours)
- postoperative endometritis and puerperal pyrexia(one week)
研究者
ahmed abdulmoneim altraigey
lecturer
Benha University