Draining the Placenta: A Simple Step with Great Impact on Postpartum Hemorrhage, Blood Transfusion Requirement, and Maternal Hemoglobin Reduction Following Vaginal Delivery: A Prospective Comparative Study

Abstract

Background: Postpartum hemorrhage (PPH) remains an important cause of maternal morbidity and mortality. Placental cord drainage is a simple, non-invasive intervention that may facilitate placental separation and reduce maternal blood loss following vaginal delivery.

Objective: To evaluate the effect of placental cord drainage on the incidence of PPH, requirement for blood transfusion, and postpartum reduction in maternal hemoglobin.

Methods: This prospective comparative study included 400 women undergoing vaginal delivery. Women were allocated to a placental cord drainage group (n=200) or control group (n=200). In the study group, the placental end of the clamped and cut umbilical cord was opened and allowed to drain, whereas it remained clamped in controls. Maternal outcomes were compared between groups.

Results: PPH occurred in 2% of the drainage group compared with 8.5% of controls (p=0.004). Blood transfusion was required in 2% and 7.5%, respectively (p=0.010). Mean reduction in hemoglobin was significantly lower with cord drainage (0.28±0.13 vs 0.70±0.31 g/dL; p<0.001).

Conclusion: Placental cord drainage was associated with lower PPH incidence, transfusion requirement, and postpartum hemoglobin reduction.