Reducing hemodynamic compromise with placental removal at 10 versus 15 minutes: a randomized clinical trial

American Journal of Perinatology
Everett F MagannJohn C Morrison

Abstract

To determine if hemodynamic compromise can be reduced with manual placental removal at 10 compared with 15 minutes. Singleton pregnancies admitted for delivery with no contraindication to a vaginal delivery were randomized to a 10-minute group (placentas manually removed if not spontaneously delivered by 10 minutes) versus a 15-minute group. The primary outcome, hemodynamic compromise, was defined as: blood loss exceeding 1000 mL and/or circulatory instability (inability to maintain blood pressure/pulse secondary to acute blood loss) and/or drop in hematocrit of ≥10 percentage points. From July 2006 to July 2010, 156 women were randomized into the 10-minute group and 156 in the 15-minute group. Women in the 15-minute group had a greater likelihood of hemodynamic compromise univariately (19.2% versus 6.4%, p = 0.001) and after adjustments for ethnicity, induction rate, duration of second stage of labor, and nulliparity (relative risk 3.03, 95% confidence interval 1.52 to 5.47, p = 0.002). Hemodynamic compromise is decreased with manual placental removal within 10 minutes of delivery compared with 15 minutes.

Citations

Dec 3, 2014·Journal de gynécologie, obstétrique et biologie de la reproduction·C DupontC Huissoud
Mar 10, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Kelly CummingsJohn C Morrison
Mar 6, 2018·Southern Medical Journal·Nader Z RabieEverett F Magann
Feb 8, 2019·Archives of Gynecology and Obstetrics·Hellen McKinnon EdwardsJens Langhoff-Roos
Mar 21, 2021·Archives of Gynecology and Obstetrics·Denise FrankeChristian Haslinger

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