Active Versus Expectant Management of the Third Stage of Labor

Christiana Care Health Services logo

Christiana Care Health Services

Status

Completed

Conditions

Postpartum Hemorrhage

Treatments

Procedure: Expectant management of the third stage of labor
Drug: Oxytocin
Procedure: Active management of the third stage of labor
Drug: Oxytocin and gentle cord traction with fundal massage

Study type

Interventional

Funder types

Other

Identifiers

NCT00473707
26008

Details and patient eligibility

About

The purpose of this study is to determine if giving oxytocin immediately after delivery causes less bleeding, transfusion needs and hastens delivery of placenta.

Full description

Postpartum hemorrhage is the leading cause of maternal mortality worldwide. During the third stage of labor, the period following the delivery of the baby until the delivery of the placenta, the patient is at increased risk for blood loss. Controversy remains as to the optimal method of delivering the placenta. Two predominant, yet very different, strategies have emerged. Expectant management is most commonly used in the United States. This includes waiting for signs of placental separation, followed by maternal pushing to expel the placenta. Then uterotonic agents are administered,usually oxytocin. This is in contrast to active management, which consists of uterotonic administration immediately following delivery of the fetus, in association with gentle umbilical cord traction and fundal massage. This is the predominant practice in the United Kingdom, where the uterotonic agents of choice are either oxytocin alone, or a combination of oxytocin and ergometrine. Comparison: Active management with oxytocin to expectant management of the third stage of labor on the effect of postpartum hemorrhage.

Enrollment

218 patients

Sex

Female

Ages

16+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Singleton gestation
  • Cephalic presentation
  • >37 weeks gestation
  • >16 years of age

Exclusion criteria

  • Multiple gestation
  • Breech presentation
  • Blood dyscrasias
  • Multiparous females Para >5
  • Placenta previa
  • Patients on anticoagulants
  • Previous history of postpartum hemorrhage
  • IUFD
  • Non-reassuring fetal heart rate pattern

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

218 participants in 2 patient groups

1
Active Comparator group
Description:
Active management of the third stage of labor- oxytocin infusion after delivery of fetus, gentle cord traction, and fundal massage
Treatment:
Drug: Oxytocin and gentle cord traction with fundal massage
Procedure: Active management of the third stage of labor
2
Other group
Description:
Expectant management of the third stage of labor
Treatment:
Drug: Oxytocin
Procedure: Expectant management of the third stage of labor

Trial contacts and locations

0

Loading...

Data sourced from clinicaltrials.gov

Clinical trials

Find clinical trialsTrials by location

Resources

© Copyright 2024 Veeva Systems