DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222320
Published: 2022-08-29

Effect of placental cord drainage on third stage of labour and in prevention of postpartum hemorrhage: randomized control trial at tertiary care centre

Srujana Lakshmi S. N., Sheela S. R.

Abstract


Background: Postpartum hemorrhage is the leading cause associated with 25% of maternal mortality. Prolonged duration of third stage of labour accounts for postpartum hemorrhage. The new trend in third stage management is placenta cord drainage (PCD). The physiology of PCD is decrease in bulkiness of placenta which consequently increases the uterine contractility. Effective uterine contraction mostly shortens third stage duration and decrease the risk for PPH

Methods: This study is a randomized control trial in which full term pregnant women admitted in labour unit at Sri Devaraj Urs medical college and research centre, Kolar, Karnataka. Total 80 women were included in this study. They were divided into two groups, control group and study group with n=40 in each group. Placental cord drainage was done in the study group. In the Group 1 placental end of the cut umbilical cord remained clamped. In the Group 2, the placental end of the cut umbilical cord unclamped immediately and collected in a vessel till the flow ceased. Thus, the drained blood was prevented from getting mixed with blood lost in the third stage. Blood lost in the third stage was collected in a clean drape sheet. Placenta was delivered by controlled cord traction after the signs of placental separation were seen. The duration of third stage was calculated using a stopwatch.

Results: In our study, the mean duration of third stage of labour in control group was 6.58minute and in study group was 2.28 minutes. Significant statistical difference was found in duration of third stage of labour.

Conclusions: PCD is noninvasive and safe intervention during third stage of labour and effective in reduction of incidence of postpartum hemorrhage.


Keywords


Placental cord drainage, Duration of third stage of labour, PPH

Full Text:

PDF

References


Wu HL, Chen XW, Wang P, Wang QM. Effects of placental cord drainage in the third stage of labour: A meta-analysis. Sci Rep. 2017;7(1):7067.

Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. United Nations maternal mortality estimation inter-agency group collaborators and technical advisory group. global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN maternal mortality estimation inter-agency group. Lancet. 2016;387(10017):462-74.

Alkış İ, Karaman E, Han A, Ark HC, Büyükkaya B. The fertility sparing management of postpartum hemorrhage: A series of 47 cases of Bakri balloon tamponade. Taiwan J Obstet Gynecol. 2015;54(3): 232-5.

Salati JA, Leathersich SJ, Williams MJ, Cuthbert A, Tolosa JE. Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database Syst Rev. 2019;4(4):CD001808.

Jongkolsiri P, Manotaya S. Placental cord drainage and the effect on the duration of third stage labour, a randomized controlled trial. J Med Assoc Thai. 2009; 92(4):457-60.

Soltani H, Dickinson F, Symonds I. Placental cord drainage after spontaneous vaginal delivery as part of the management of the third stage of labour. Cochrane Database Syst Rev. 2005;(4):CD004665.

Sharma JB, Pundir P, Malhotra M, Arora R. Evaluation of placental drainage as a method of placental delivery in vaginal deliveries. Arch Gynecol Obstet. 2005;271(4):343-5.

Thomas IL, Jeffers TM, Brazier JM, Burt CL, Barr KE. Does cord drainage of placental blood facilitate delivery of the placenta? Aust N Z J Obstet Gynaecol. 1990;30(4):314-8.

Mithala S, Sukonpan K, Chunlaphakhee C. The comparison of blood loss after vaginal delivery between placental cord drainage and cord clamping before placental delivery in Buddhachinaraj Phitsanulok Hospital. Thai J Obstet Gynaecol. 2018; 26(1):34-41.

Mohamed A, Jongkolsiri P, Manotaya S. Placental cord drainage and the effect on the duration of third stage labour, a randomized controlled trial. J Med Assoc Thai. 2009;92(4):457-60.

Kaba M, Engin Üstün Y, Yapar Eyi EG, Timur H, Ünlü BS, Öksüzoğlu, A. Placental blood drainage shortens duration of the third stage of labor in women slowly administered 20 IU oxytocin. Gynecol Obstet Reprod Med. 2017;23(1):6-10.

Roy P, Sujatha MS, Bhandiwad A, Biswas B, Chatterjee A. Placental blood drainage as a part of active management of third stage of labour after spontaneous vaginal delivery. J Obstet Gynaecol India. 2016;66(1):242-5.

Choppala N, Ramana PV. A study to evaluate the effectiveness of simple technique of placental drainage in control of third stage blood loss. MRIMS J Health Sci. 2016;4:2-5.

Chen XW, Wang P, Wang QM. Effects of placental cord drainage in the third stage of labour: A meta-analysis. Sci Rep. 2017;7(1):7067.

Vasconcelos FB, Katz L, Coutinho I, Lins VL, de Amorim MM. Placental cord drainage in the third stage of labor: Randomized clinical trial. PLoS One. 2018;13(5):e0195650.

Amorim M. Placental cord drainage in the third stage of labor. Int J Obstet Gynecol. 2015;131:E226.

Chaudhary M. Placental cord drainage during third stage of labour: a randomized control trial at a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2020;9(3):1143-7.

Afzal MB, Bushra N, Waheed K, Sarwar A, Awan NU. Role of placental blood drainage as a part of active management of third stage of labour after spontaneous vaginal delivery. J Pak Med Assoc. 2019;69(12):1790-3.

Meena SA, Bebincy DS. Placental cord blood drainage after vaginal delivery as part of the management of third stage of labour: a systematic review of randomized controlled clinical trial. Int J Reprod Contracept Obstet Gynecol. 2017;6:4001-5.