Postpartum Haemorrhage Clinical Trial
Official title:
Impact of Controlled Cord Traction During the Third Stage of Labour on the Incidence of Post Partum Haemorrhage
The primary purpose of the trial is to evaluate whether the management of placental delivery
with controlled cord traction (CCT) reduces the incidence of postpartum haemorrhage,
compared with management waiting for clinical signs of spontaneous placental separation, in
women with vaginal delivery receiving prophylactic oxytocin for the management of the third
stage of labour.
The hypothesis is that CCT, by reducing the length of the third stage of labour, facilitates
early postpartum uterine contraction and local haemostasis and decreases post partum blood
loss.
In this randomized controlled trial, conducted in 6 maternity units, information will be
provided to eligible women during a prenatal visit in late pregnancy. Once in labour ward,
during labour and before delivery, and if eligible and willing to participate, the woman
will be randomly allocated to the intervention or reference group.
In all women, immediately after the birth of the baby, 5 IU prophylactic oxytocin will be
intravenously administered, the umbilical cord will be early clamped and cut, and a
collector bag placed under the woman's buttocks.
In the intervention group, controlled cord traction will be applied as soon as a firm
uterine contraction is obtained, and until placental delivery occurs.
In the reference group, clinical signs of placental separation will be awaited for, and then
placental expulsion may be helped through maternal pushing and/or hypogastric pressure.
All other aspects of the management of the third stage will be standardized and common to
all women.
On day 2 postpartum, a venous blood sample will be collected to measure plasma haemoglobin
and haematocrit. On the same day, a questionnaire will be filled in by the woman to assess
her satisfaction.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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