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Clinical Obstetrics

Poster Session 4

(1028) The Impact of Placental Cord Drainage on Third Stage of Labor: A Randomized Controlled Trial

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: We aimed to investigate the impact of placental drainage during the third stage of labor on key obstetric outcomes, specifically third-stage length, maternal blood loss and postpartum hemorrhage (PPH) incidence.

Study Design: In a randomized controlled trial at a high-volume tertiary obstetric center between 2021-2022, 212 pregnant women with a singleton uncomplicated pregnancy were enrolled. They were randomly assigned to two groups: an intervention group of 104 women receiving placental drainage and a control group of 108 women receiving standard care without drainage. Placental drainage involved unclamping the cut umbilical cord, allowing blood to drain into a plastic bag placed below, which was weighed after placenta removal. All participants received 10 units of oxytocin immediately after delivery, according to department's standard care. The allocation was concealed and blinded to the participants but not to the care providers.

Results:

The two groups were similar in their baseline characteristics. No significant differences were observed between the intervention and control groups regarding the duration of the third stage of labor (10.56 minutes ± 6.12 vs. 10.95 ± 6.33, p=0.65), the incidence of PPH (3.84% vs. 7.41%, p=0.38) or the amount of bleeding during the third stage of labor (292 grams ± 200 vs. 300 ± 242, p=0.79).
Furthermore, no significant differences were observed in the amount of bleeding in a subgroup analysis for nulliparity (356 ± 246 vs. 330 ± 240, p=0.68), multiparity (265 ± 171 vs. 289 ± 244, p=0.50), women who received oxytocin during labor (296 ± 198 vs. 289 ± 238, p=0.39) or not (287 ± 204 vs. 317 ± 250, p=0.59).

Conclusion: Placental drainage during the third stage of labor offers no benefit on third-stage length, PPH incidence or maternal blood loss.