Umbilical Cord Drainage to Prevent Postpartum Hemorrhage
Relationship Between Umbilical Cord Drainage and Postpartum Hemorrhage: A Randomized Single-Blind Clinical Trial.
Universidad Nacional Autonoma de Honduras
400 participants
Feb 15, 2026
INTERVENTIONAL
Conditions
Summary
This study aims to analyze whether there is a significant difference in the occurrence of postpartum hemorrhage between women who underwent umbilical cord drainage and those who did not. Variables such as estimated blood loss volume, drop in hemoglobin levels, and the need for additional maneuvers or treatments to control hemorrhage will be examined. The research will be conducted under a parallel-group clinical trial design at the Hospital Escuela Universitario. Post-birth umbilical cord drainage may contribute to a lower frequency of postpartum hemorrhage compared to not performing it.
Eligibility
Inclusion Criteria6
- Pregnant women aged 18-49 years.
- Singleton pregnancy.
- Gestational age ≥37 weeks.
- active labor with cephalic presentation.
- Planned for vaginal delivery.
- Capable of providing informed consent.
Exclusion Criteria7
- Planned or emergent cesarean section.
- Instrumental delivery (e.g., forceps, vacuum).
- Antepartum hemorrhage.
- Severe anemia (Hemoglobin \<8 g/dL) or specific hematological disorders (e.g., sickle cell disease, thalassemia, hemophilia, thrombocytopenia \<100,000/µL).
- Use of anticoagulant medication.
- Non-cephalic fetal presentation (e.g., breech, transverse).
- Refusal to participate or inability to provide informed consent.
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Interventions
Following delivery of the newborn and immediate clamping/cutting of the umbilical cord, the maternal end of the cord is unclamped and allowed to drain passively. The cord is held over a sterile, graduated collection drape (Brass-V Drape) to facilitate the complete, gravity-dependent emptying of the residual placental blood (approximately 50-100 mL) prior to placental delivery. The procedure is completed within 1-3 minutes, after which standard controlled cord traction is applied to assist placental expulsion. This is a non-invasive adjunct to active management of the third stage of labor.
This arm receives the standard, evidence-based active management of the third stage of labor, as per institutional protocol, without the specific addition of umbilical cord drainage. The procedure includes immediate administration of a prophylactic uterotonic agent (e.g., oxytocin), delayed cord clamping (as per routine practice), controlled cord traction with counter-pressure on the uterus (Brandt-Andrews maneuver) to assist placental delivery, and uterine massage after placental expulsion. All blood loss is collected and measured in a standard graduated drape. This represents the current standard of care against which the experimental intervention is compared.
Locations(2)
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NCT07401160