Cord Traction Versus Manual Removal for Placental Delivery during Cesarean Section

Abstract

Background: Cesarean section is the most common major surgery performed on pregnant women around the world. It is necessary to apply the practical skills training and current knowledge, especially in the procedure that would need to help keep mothers alive and the fetus safe. Objective: To study the efficacy of the umbilical cord traction versus manual removal for placenta delivery in the third stage of labor during the cesarean section. Materials and Methods: The present study was a retrospective comparative study conducted in Srisangwornsukhothai Hospital between January 2017 and January 2020. The purposive sample size was calculated by using a power of 80%, with a significant level of 5%. One hundred twenty pregnant women were divided into two groups, sixty pregnant women each, the cord traction as the first group and the manual removal as the second group for placental delivery during the cesarean section. The significance of the two groups were compared by using the independent t-test (p<0.05), 95% confidence interval (CI), and the Mann-Whitney U test. Results: Several outcomes of the umbilical cord traction were better than the manual removal, such as decrease time of the operation and a statistically significant decrease in hemoglobin (p<0.001, 0.049, respectively). However, there was not a statistically significant decrease of blood loss, fever after surgery, or the length of stays (p=0.839, 0.056, 0.175, respectively). Only one outcome, the time of the third stage of labor, was slightly more than the manual removal group for placental delivery during the cesarean section with statistically significance (p=0.003). Conclusion: The umbilical cord traction maneuver for the delivery of the placenta had more advantages than the manual removal maneuver. This technique should be a recommendation during the cesarean section. Keywords: Cesarean section, Umbilical cord traction, Placental delivery