Placental Drainage Versus No Placental Drainage After Vaginal Delivery in the Management of Third Stage of Labour: A Randomized Study

Yıl 2019, Cilt: 50 Sayı: 1, 26 - 29, 14.03.2019

Evrim Bostancı Ergen , Çetin Kılıççı Pınar Kumru , Çiğdem Yayla Abide , Ezgi Darıcı Mustafa Eroğlu

https://doi.org/10.16948/zktipb.457289

Öz

Objective: To
asses the effectiveness of placental blood drainage after spontaneous vaginal
delivery in reducing the duration, the pain and blood loss during third stage
of labour against no placental drainage.

Methods:
In this randomized controlled study, 222 pregnant women who admitted to Zeynep
Kamil Women and Children’s Health Training and Research Hospital from December
2016 and July 2017 were included. They were randomized into study(111) or
control(111) group when they delivered vaginally. In study group; umbilical
cord was clamped from fetal side but unclamped from maternal side. After that
unclamped side of umblical cord was left open to drain the blood until the flow
stopped. In control group the umblical cord was clamped both sides.

Results: The
duration of third stage of labour was 18,39±6,85 min in the study group and
22,78±5,90 min in the control group(p<0,0001). The mean blood loss in study
group was 212,75±12,1 and was 308,42±18,4 ml in the control group(p<0,0001).
The mean respective visual analog scale (VAS) scores in study group and control
group were 5,65 and 6,58 (p<0,0001).

Conclusions: Placental
blood drainage was effective in reducing the duration of the third stage of
labour, the blood loss in the third stage of labour, and also the pain in the third
stage of labour. 

Anahtar Kelimeler

Placental drainage, duration, third stage of labour

Plasental Drenajın Vajinal Doğumun Üçüncü Aşamasının Yönetiminde Etkinliğinin Karşılaştırılması

Öz

Amaç: Spontan vajinal doğum sonrasında plasental drenajın etkinliğini değerlendirmek.

Yöntem: Bu randomize kontrollü çalışmaya, Aralık 2016 ve Temmuz 2017 tarihleri ​​arasında Zeynep Kamil Kadın ve Çocuk Sağlığı Eğitim ve Araştırma Hastanesi'ne başvuran 222 gebe kadın dahil edildi. Spontan vajinal doğum sonrasında olgular çalışma (111) veya kontrol (111) grubu olarak randomize edildi. Çalışma grubunda; Göbek kordonun fetal yönü klemplendi,  maternal tarafı akış duruncaya kadar kanı boşaltmak için açık bırakıldı.  Kontrol grubunda umblikal kord her iki taraftan kleplendi.

Bulgular: Doğumun üçüncü evresinin süresi çalışma grubunda 18,39 ± 6,85 dk, kontrol grubunda 22,78 ± 5,90 dk idi (p <0,0001). Çalışma grubunda ortalama kan kaybı 212,75 ± 12,1 olup kontrol grubunda 308,42 ± 18,4 ml idi (p <0,0001). Çalışma ve kontrol grubunda VAS skorları 5,65 ve 6,58'dir (p <0,0001).

Sonuç: Plasental drenaj, doğumun üçüncü evresinin süresini, doğumun üçüncü evresindeki kan kaybını ve doğumun üçüncü evresindeki ağrıyı azaltmada etkili olabilir.

Anahtar Kelimeler

Plasenta drenaj, doğumun üçüncü evresi, kan kaybı

Kaynakça

• 1-Lethaby A, Farquhar C. Antifibrinolytics for heavy menstrual bleeding. Cochrane database of systematic reviews, 2000; Issue 4. Art No. CD000249.
• 2- Ibrahim Alanbay, Mustafa Ozturk, Emre Karasahin. Management of Postpartum Haemorrhage Due to Uterine Anomalies or the Asymmetric Uterus Growth: Two Case Report andLiteratureReview.Turkiye Klinikleri J Gynecol Obst 2017;27(4):200-4.
• 3-Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066- 74.
• 4-Meena SA, Bebincy DS, Devika. 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.
• 5- Sharavage JC, Silpa P. Randomized controlled trial of placental blood drainage for the prevention of postpartum haemorrhage. J Obstet Gynaecol India. 2007;57(3):213–5.
• 6-Piphat Jongkolsiri, Saknan Manotaya. Placental cord drainage and the effect on the duration of third stage of labour: randomized controlled trial. J Med Assoc. 2009 Apr;92(4):457-60.
• 7-Winter C, Macfarlane A, Deneux-Tharaux C,Zhang W-H, Alexander S, Brocklehurst P, Bouvier-Colle M-H, Prendiville W, Cararach V, Roosmalen J van, Berbik I, KleinM, Ayres-de-Campos D, Erkkola R,Chiechi LM, Langhoff-Roos J,Stray-Pedersen B,Troeger C. Variation in policies for management of postpartum hemorrhage in Europe .RCOG 2007 BJOG An international journal of obstetrics and gynecology .march 2007, p 845-54.
• 8-Razmkhah N, Kordi M, Yousophi Z. The effects of cord drainage on the length of third stage of labour. Scientific Journal of Nursing and Midwifery of Mashad University 1999; 1:10–4.
• 9- 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. The Journal of Obstetrics and Gynecology of India 2016 66(S1):S242–S245. DOI 10.1007/s13224-016-0857-3
• 10- Giacalone PL, Vignal J, Daures JP,Boulot P, Hedon B, Laffargue F. A randomized evaluation of two techniques of management of third stage of labour in women at low risk of postpartum hemorrhage. BJOG. 2000;107(3):396–400.
• 11-Gulati N, Chauhan MB, Rana M. Placental blood drainage in management of third stage of labour. J Obstet Gyneacol India. 2001;51:46–8.
• 12-Asicioglu, Unal C, Asicioglu BB, Temizkan O, Yildirım G, Arici B, Gulova S. Influence of placental cord drainage in management of the third stage of labor: a multicenter randomized controlled study. Am J Perinatol. 2015; 32, 343–350.
• 13-Mohammed M, Jeborry AI. Efficacy of cord blood drainage, at college of Medicine. Department of Obstetrics Gynecology, Babylon University. Med J Babylon. 2010;3: 54-9.
• 14- Soltani H, Poulose TA, Hutchon DR. Placental cord drainage after vaginal delivery as part of management of the third stage of labour. Cochrane Database Syst Rev. 2011 Sep 7;(9):CD004665.
• 15- Hang-lin Wu, Xiao-wen Chen, Pei Wang, Qiu-meng Wang. Effects of placental cord drainage in the third stage of labour: A meta-analysis Sci Rep.2017;7: 7067.16- Soltani H, Dickinson F, Leung TN. Placental cord drainage in the third stage of labour on feto-maternal transfusion: a systematic review. Evid Based Midwifery. 2005;3(2):64–8.
• 17-Lankeshwara, D. Placental cord drainage after vaginal delivery in the management of the third stage of labour. Post Graduate of Medicine (PGIM), University of Colombo, Sri Lanka. Thesis for MD (Obsterics and Gynecology) Part 11 (2008).112-135.
• 18- 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 May 2;13(5):e0195650.