Prevention of Post-partum Haemorrhage (TRACOR)
Impact of Controlled Cord Traction During the Third Stage of Labour on the Incidence of Post Partum Haemorrhage
The primary purpose of the trial is to evaluate whether the management of placental delivery with controlled cord traction (CCT) reduces the incidence of postpartum haemorrhage, compared with management waiting for clinical signs of spontaneous placental separation, in women with vaginal delivery receiving prophylactic oxytocin for the management of the third stage of labour.
The hypothesis is that CCT, by reducing the length of the third stage of labour, facilitates early postpartum uterine contraction and local haemostasis and decreases post partum blood loss.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
In this randomized controlled trial, conducted in 6 maternity units, information will be provided to eligible women during a prenatal visit in late pregnancy. Once in labour ward, during labour and before delivery, and if eligible and willing to participate, the woman will be randomly allocated to the intervention or reference group.
In all women, immediately after the birth of the baby, 5 IU prophylactic oxytocin will be intravenously administered, the umbilical cord will be early clamped and cut, and a collector bag placed under the woman's buttocks.
In the intervention group, controlled cord traction will be applied as soon as a firm uterine contraction is obtained, and until placental delivery occurs.
In the reference group, clinical signs of placental separation will be awaited for, and then placental expulsion may be helped through maternal pushing and/or hypogastric pressure.
All other aspects of the management of the third stage will be standardized and common to all women.
On day 2 postpartum, a venous blood sample will be collected to measure plasma haemoglobin and haematocrit. On the same day, a questionnaire will be filled in by the woman to assess her satisfaction.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Paris, France, 75014
- Maternité de Port-Royal
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria :
- Age ≥ 18
- Expected vaginal delivery
- Gestational age ≥ 35 weeks
- Singleton pregnancy
Exclusion criteria :
- Age <18
- Planned caesarean delivery
- Severe hemorrhagic disease
- Multiple Pregnancy
- Placenta praevia
- Intra uterine fetal death
- No health insurance coverage
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: controlled cord traction
Controlled cord traction will be applied as soon as a firm uterine contraction is obtained, and until placental delivery occurs.
|
In the intervention group, controlled cord traction will be applied as soon as a firm uterine contraction is obtained, and until placental delivery occurs
|
|
Active Comparator: clinical signs of placental separation
Clinical signs of placental separation will be awaited for, and then placental expulsion may be helped through maternal pushing and/or hypogastric pressure
|
Clinical signs of placental separation will be awaited for, and then placental expulsion may be helped through maternal pushing and/or hypogastric pressure
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Incidence of postpartum haemorrhage, defined as a measured postpartum blood loss greater than 500 mL
Time Frame: immediately to two hours after delivery
|
immediately to two hours after delivery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Severe postpartum haemorrhage, defined as a measured postpartum blood loss greater than 1000mL
Time Frame: immediately to two hours after delivery
|
immediately to two hours after delivery
|
|
Measured postpartum blood loss at 30 minutes after delivery
Time Frame: at 30 minutes after delivery
|
at 30 minutes after delivery
|
|
Total measured postpartum blood loss
Time Frame: Time after delivery
|
Time after delivery
|
|
Curative postpartum uterotonic treatment
Time Frame: Time after delivery
|
Time after delivery
|
|
Postpartum transfusion
Time Frame: Time after delivery
|
Time after delivery
|
|
Postpartum embolization or surgery for haemorrhage
Time Frame: Time after delivery
|
Time after delivery
|
|
Peripartum haemoglobin delta
Time Frame: Time after delivery
|
Time after delivery
|
|
Peripartum haematocrit delta
Time Frame: Time after delivery
|
Time after delivery
|
|
Duration of third stage of labour
Time Frame: time before delivery
|
time before delivery
|
|
Deliveries with manual removal of placenta
Time Frame: 30 minutes
|
30 minutes
|
|
Potential adverse events: uterine inversion, cord rupture, pain during third stage of labour
Time Frame: Time after delivery
|
Time after delivery
|
|
Woman's satisfaction
Time Frame: two days after delivery
|
two days after delivery
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Catherine Deneux, MD, PhD, Assistance Publique Hopitaux De Paris
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- P081206
- AOM09161 (Other Grant/Funding Number: AOM09161)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.