The Effect of Placental Cord Drainage on Postpartum Blood Loss
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Tennessee
- Enrollment
- 71
- Locations
- 2
- Primary Endpoint
- Qualitative Blood Loss
Study Overview
Brief Summary
To determine if placental cord drainage decreases the blood loss after spontaneous vaginal delivery
Detailed Description
Postpartum hemorrhage complicates 3% of pregnancies in the United States and is a leading cause of maternal morbidity and mortality. ACOG defines PPH as cumulative blood loss greater than 1000cc; however a blood loss >500cc should be considered abnormal. Primary PPH occurs in the first 24 hours and is largely secondary to uterine agony. ACOG as well as the WHO recommend active management of the third stage of labor to prevent PPH. This includes oxytocin administration, uterine massage, and gentle cord traction. Placental cord drainage (PCD) is the unclamping of the umbilical cord to allow for drainage of the blood from the placenta. It is another technique used to shorten the third stage of labor; however, it has not been well studied
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 45 Years (Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Singleton Gestation
- •Ages 18-45
- •English Speaking
- •Third Trimester Gestation
Exclusion Criteria
- •Operative Vaginal Delivery
- •Multiple Gestation
- •Cesarean Delivery
- •Episiotomy
- •3rd or 4th degree laceration
- •Less than the Third Trimester of Pregnancy
- •Chorioamnionitis
- •History of Postpartum Hemorrhage
- •Macrosomic Infant
Outcomes
Primary Outcomes
Qualitative Blood Loss
Time Frame: Through delivery completion, on average 30 minutes
Total Volume in Underbuttocks Drape - Initial Volume in Drape (amniotic fluid etc) + blood in laparotomy sponges
Secondary Outcomes
- Blood Loss > 500 cc(30 minutes to 1 hour after delivery)
- Need for Blood Transfusion(Up to 24 hours postpartum)
- Duration of Third Stage of Labor(On average 30 minutes)
- Postpartum Hemorrhage(30 minutes to 1 hour after delivery)
- Retained Placenta(30 minutes after delivery)
- Percent Drop in HgB and Hct(Up to 48 hours following delivery)
- Additional Uterotonic Administration(30 minutes to 1 hour following delivery)
- Endometritis(Up to 12 weeks following delivery)