None listed
Conditions
Brief summary
Placental delivery is accelerated by placental cord drainage at vaginal delivery. Hypothesis: This effect may extrapolate to caesarean section, where the blood loss from the vascular uterine incision may make time to delivery of placenta particularly important. Aim: To determine if drainage of the placental cord at caesarean section accelerates delivery of the placenta, compared to delayed clamping of the placental cord. Methods: Randomised Controlled Trial with Intention to Treat Analysis. Women at elective caesarean section without antenatal evidence of placental disease or fetal compromise, randomised to Intervention (Placental Cord Drainage) or Control (Delayed Cord Clamping).
Interventions
Placental Cord Drainage
- ie. immediate clamping and cutting of the placental cord at caesarean section, followed by drainage of the placental side of the cord into a receptacle).
- this will be performed by the operating surgeon (ie. Consultant Obstetrician or Obstetrics Registrar)
- this is a once-off procedure, at the time of elective caesarean section
- this will occur in theatre at an urban hospital, with Obstetrics services
- adherence to the intervention/control will be documented at th
Placental Cord Drainage - ie. immediate clamping and cutting of the placental cord at caesarean section, followed by drainage of the placental side of the cord into a receptacle). - this will be performed by the operating surgeon (ie. Consultant Obstetrician or Obstetrics Registrar) - this is a once-off procedure, at the time of elective caesarean section - this will occur in theatre at an urban hospital, with Obstetrics services - adherence to the intervention/control will be documented at the time of caesarean, and rationale for deviation will be documented. If not documented at the time, patient medical record will be consulted by study team to determine a possible rationale.
Sponsors
Michael Fahy
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Elective Caesarean Section Singleton Pregnancy Cephalic Presentation Gestation 37+0 to 41+6
Exclusion criteria
• Placenta praevia on most recent ultrasound • Suspected placenta accreta spectrum • Suspected intrauterine growth restriction • Oligohydramnios on most recent ultrasound • Fetal Death in Utero • Suspected Placental Abruption • Known fetal anatomical abnormality • Abnormal fetal dopplers of most recent ultrasound • Preterm delivery
Outcome results
None listed