- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03626844
Maternal Outcomes Following Manual Lysis of the Placenta.
February 12, 2020 updated by: HaEmek Medical Center, Israel
Maternal Outcomes Following Manual Lysis of the Placenta After Fifteen Compared to Thirty Minutes. A Randomized Controlled Trial.
Comparison of maternal outcomes following manual lysis of placenta 15 vs 30 minutes after delivery.
A primary outcome of the drop in hemoglobin will be compared between the two groups.
Secondary outcomes include maternal satisfaction, time to first breastfeeding, length of hospital stay, infection rate etc.
Study Overview
Status
Suspended
Conditions
Detailed Description
Women undergoing spontaneous term vaginal delivery with epidural analgesia will be randomly assigned into one of two groups: 1. manual lysis of placenta 15 minutes after delivery.
2. waiting 30 minutes and then manual lysis of placenta.
Both groups will be managed actively during the 3rd stage of delivery, including oxytocin administration and controlled cord traction.
Women who develop active bleeding will be promptly treated with manual lysis and excluded from the study.
Manual lysis will be performed under epidural analgesia, and prophylactic antibiotics will be administered.
Primary outcome of comparison between the two groups: hemoglobin drop after delivery.
Secondary outcomes include: maternal satisfaction, time to first breastfeeding, length of hospital stay, infection rate etc.
Study Type
Interventional
Enrollment (Anticipated)
100
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
-
Afula, Israel
- Haemek Medical Center
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 45 years (ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Term spontaneous vaginal delivery.
- Singleton Pregnancy.
- Epidural Analgesia during delivery.
- Age between 18 and 45 years.
Exclusion Criteria:
- Active bleeding after delivery that warrants prompt removal of placenta regardless of time from delivery.
- Vacuum Extraction.
- Intrapartum Infection.
- Intrapartum fever above 38 degrees celsius.
- Wide 3rd and 4th degree perineal tears that mandate suturing under general anaesthesia.
- Thalassemia Carriers.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
EXPERIMENTAL: Manual Lysis after 15 minutes (Intervention)
Manual Lysis of Placenta 15 minutes after Delivery.
|
Manual Lysis of Placenta after 15 minutes: We administer prophylactic antibiotics, under epidural analgesia, under aseptic conditions, we perform manual lysis of placenta by introducing the hand through the vagina to the uterine cavity, separating and removing the placenta.
Other Names:
|
|
ACTIVE_COMPARATOR: Manual lysis after 30 minutes (Control)
Waiting 30 minutes after delivery and then manual lysis of the placenta.
|
Manual Lysis of Placenta after 30 minutes: We administer prophylactic antibiotics, under epidural analgesia, under aseptic conditions, we perform manual lysis of placenta by introducing the hand through the vagina to the uterine cavity, separating and removing the placenta.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hemoglobin Drop
Time Frame: within 24 hours after delivery
|
The difference between Hemoglobin levels before and after delivery
|
within 24 hours after delivery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of Blood Products Given
Time Frame: 7 days
|
Number and type of blood products given peripartum
|
7 days
|
|
Blood Loss
Time Frame: 7 days
|
Calculation of estimated blood loss during delivery by accepted formulas
|
7 days
|
|
Febrile morbidity
Time Frame: within one week of delivery
|
Rate of developing fever after delivery
|
within one week of delivery
|
|
First Nursing
Time Frame: 7 days
|
Time until first breastfeeding
|
7 days
|
|
Hospital Stay
Time Frame: 7 days
|
Length of Hospital stay in days
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7 days
|
|
Maternal Satisfaction
Time Frame: 7 days
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Level of maternal satisfaction from the delivery process and interventions as evaluated by a numerical scale from 1 to 5 with 5 being highly satisfied
|
7 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Chair: Raed Salim, M.D., HaEmek Medical Center, Afula, Israel
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Deneux-Tharaux C, Macfarlane A, Winter C, Zhang WH, Alexander S, Bouvier-Colle MH; EUPHRATES Group. Policies for manual removal of placenta at vaginal delivery: variations in timing within Europe. BJOG. 2009 Jan;116(1):119-24. doi: 10.1111/j.1471-0528.2008.01996.x.
- Weeks AD. The retained placenta. Best Pract Res Clin Obstet Gynaecol. 2008 Dec;22(6):1103-17. doi: 10.1016/j.bpobgyn.2008.07.005. Epub 2008 Sep 14.
- Shinar S, Schwartz A, Maslovitz S, Many A. How Long Is Safe? Setting the Cutoff for Uncomplicated Third Stage Length: A Retrospective Case-Control Study. Birth. 2016 Mar;43(1):36-41. doi: 10.1111/birt.12200. Epub 2015 Nov 10.
- Tuncalp O, Souza JP, Gulmezoglu M; World Health Organization. New WHO recommendations on prevention and treatment of postpartum hemorrhage. Int J Gynaecol Obstet. 2013 Dec;123(3):254-6. doi: 10.1016/j.ijgo.2013.06.024. Epub 2013 Aug 30.
- Obajimi GO, Roberts AO, Aimakhu CO, Bello FA, Olayemi O. An appraisal of retained placentae in ibadan: a five year review. Ann Ib Postgrad Med. 2009 Jun;7(1):21-5. doi: 10.4314/aipm.v7i1.64058.
- Morales M, Ceysens G, Jastrow N, Viardot C, Faron G, Vial Y, Kirkpatrick C, Irion O, Boulvain M. Spontaneous delivery or manual removal of the placenta during caesarean section: a randomised controlled trial. BJOG. 2004 Sep;111(9):908-12. doi: 10.1111/j.1471-0528.2004.00228.x.
- Setubal A, Clode N, Bruno-Paiva JL, Roncon I, Graca LM. Vesicouterine fistula after manual removal of placenta in a woman with previous cesarean section. Eur J Obstet Gynecol Reprod Biol. 1999 May;84(1):75-6. doi: 10.1016/s0301-2115(98)00305-4.
- Akinola OI, Fabamwo AO, Oludara B, Akinola RA, Oshodi YA, Adebayo SK. Ruptured uterus and bowel injury from manual removal of placenta: a case report. Niger Postgrad Med J. 2012 Sep;19(3):181-3.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
November 20, 2018
Primary Completion (ANTICIPATED)
September 1, 2020
Study Completion (ANTICIPATED)
September 1, 2020
Study Registration Dates
First Submitted
August 8, 2018
First Submitted That Met QC Criteria
August 8, 2018
First Posted (ACTUAL)
August 13, 2018
Study Record Updates
Last Update Posted (ACTUAL)
February 13, 2020
Last Update Submitted That Met QC Criteria
February 12, 2020
Last Verified
February 1, 2020
More Information
Terms related to this study
Other Study ID Numbers
- 0022-18EMC
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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.
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