Comparations Controlled Cord Traction and Manual Removal of Placenta in Caesarean Section: Prospective Study of Somali Pregnant Women

Abstract

Aim: This study sought to examine the intraoperative and postoperative outcomes of Controlled cord traction and manual removal of the placenta in the third stage of labour during the caesarean section. Methods: We prospectively enrolled pregnancies who were admitted to the clinic of the Department of obstetrics and Gynaecology for caesarean section (Pfannenstiel method) in addition to providing sociodemographic data (age, body mass index) and clinical data (haemoglobin, total operative time, removed placenta total time, postpartum haemorrhage, need to blood transfusion, hospital stay, intensive care unit (ICU) admission, postoperative eating and drinking time, and intrabdominal blood). Results: Of 196 participating women, 98 performed controlled cord traction removal of the placenta, and 98 performed manual removal. The controlled cord traction removal of the placenta group and the manual removal of the placenta group had similar blood loss (haemoglobin drop) and postpartum haemorrhage (p>0.05). In the controlled cord traction removal of placenta group, significant intra-operative findings were shorter removal of placenta time (18.7±10.6 vs 28.6±13.1 second, p=0.0001), shorter total operative time (36.3±10.7 vs 41.8±11.4, p=0.003) and lower prevalence of presenting intrabdominal blood (12.2% vs 26.7%, p=0.021). Significant postoperative findings were earlier eating time ( 15.0±7.3 vs 19.6±14.4 hours, p=0.011) and lower incidence of endometritis ( 1% vs 4.1%, p=0.042) compared with the manual removal of placenta. Conclusion: The umbilical cord traction maneuverer for the placenta delivery had more advantages than the manual removal maneuverer. This technique should be recommended during the third stage of labour during the caesarean section.