Comparison of Placental Cord Blood Drainage and No Drainage in the Management of the Third Stage of Labour

Abstract

Objective:
To compare the effectiveness of placental cord blood drainage with no drainage in reducing the duration of the third stage of labour, maternal blood loss, and postpartum haemorrhage.

Study Design:
Randomised controlled trial.

Setting and Duration:
Department of Obstetrics and Gynaecology, a tertiary care teaching hospital, from January to December 2024.

Methods:
A total of 120 women with uncomplicated singleton term pregnancies undergoing spontaneous vaginal delivery were randomly allocated into two equal groups. Group A (n = 60) underwent placental cord blood drainage after delivery of the neonate, while Group B (n = 60) received no drainage. Primary outcomes included duration of the third stage of labour and estimated maternal blood loss. Secondary outcomes were incidence of postpartum haemorrhage and requirement for additional uterotonics. Statistical analysis was performed using SPSS version 26.

Results:
The mean duration of the third stage of labour was significantly shorter in the cord drainage group (5.8 ± 1.9 minutes) compared with the no-drainage group (8.6 ± 2.4 minutes; p < .001). Mean blood loss was also significantly lower in Group A (182 ± 55 mL) than in Group B (241 ± 68 mL; p < .001). Postpartum haemorrhage occurred in 3.3% of women in the drainage group compared with 11.7% in the control group.

Conclusion:
Placental cord blood drainage is a simple, safe, and effective intervention that significantly reduces the duration of the third stage of labour and maternal blood loss. Its routine use alongside active management of the third stage of labour is recommended.