To determine if placental cord drainage decreases the blood loss after spontaneous vaginal delivery
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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
71
Immediately after vaginal delivery following delayed cord clamping and cutting of the cord, the cord will be unclamped and blood will be drained from the placenta until cessation of flow.
Placenta Blood Not Drained
Regional One Health
Memphis, Tennessee, United States
Qualitative Blood Loss
Total Volume in Underbuttocks Drape - Initial Volume in Drape (amniotic fluid etc) + blood in laparotomy sponges
Time frame: Through delivery completion, on average 30 minutes
Duration of Third Stage of Labor
After neonatal delivery to delivery of the placenta
Time frame: On average 30 minutes
Retained Placenta
Placenta not delivered \> 30 minutes
Time frame: 30 minutes after delivery
Postpartum Hemorrhage
Blood Loss Greater than 1000cc
Time frame: 30 minutes to 1 hour after delivery
Blood Loss > 500 cc
Greater than average postpartum blood loss
Time frame: 30 minutes to 1 hour after delivery
Need for Blood Transfusion
In event of HgB \<7 or active bleeding
Time frame: Up to 24 hours postpartum
Percent Drop in HgB and Hct
Lab draw following delivery
Time frame: Up to 48 hours following delivery
Additional Uterotonic Administration
Medications administered to stop postpartum bleeding
Time frame: 30 minutes to 1 hour following delivery
Endometritis
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Infection of myometrium of uterus
Time frame: Up to 12 weeks following delivery