Spontaneous delivery or manual removal of the placenta during caesarean section: a randomised controlled trial

Michel Morales; Gilles Ceysens; Nicole Jastrow; Caroline Viardot; Gilles Faron; Yvan Vial; Christine Kirkpatrick; Olivier Irion; Michel Boulvain

doi:10.1111/j.1471-0528.2004.00228.x

Spontaneous delivery or manual removal of the placenta during caesarean section: a randomised controlled trial

Michel Morales, Gilles Ceysens, Nicole Jastrow, Caroline Viardot, Gilles Faron, Yvan Vial, Christine Kirkpatrick, Olivier Irion, Michel Boulvain

Onderzoeksoutput: Article › peer review

31 Citaten (Scopus)

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OBJECTIVE: To compare blood loss with spontaneous delivery and manual removal of the placenta during caesarean section.

DESIGN: A randomised controlled trial.

SETTING: Four university hospitals between September 1999 and June 2002.

POPULATION: A total of 472 women delivering by caesarean section at term were randomised to spontaneous placental delivery (n= 235) or manual removal (n= 237).

METHODS: The allocation was made by opening the next available of a series of sealed opaque envelopes and derived from a computer-generated list of numbers.

MAIN OUTCOME MEASURES: Significant blood loss, defined as either a drop in haemoglobin of greater than 2.5 g/dL, or the need for blood transfusion.

RESULTS: The mean interval between delivery of the newborn and the placenta was longer in the spontaneous delivery group (3.4 vs 1.9 minutes), but the mean duration of the operation was similar. Significant blood loss occurred in 30 women (13%) in the spontaneous delivery group and 49 women (21%) in the manual removal one (RR 0.62; 95% CI 0.41-0.94). Post-operative fever affected 6 and 5 cases, respectively, and antibiotics were used in 14 and 12 cases, respectively.

CONCLUSIONS: Allowing spontaneous delivery of the placenta reduces significant blood loss without increasing operating time.

Originele taal-2	English
Pagina's (van-tot)	908-12
Aantal pagina's	5
Tijdschrift	BJOG
Volume	111
Nummer van het tijdschrift	9
DOI's	https://doi.org/10.1111/j.1471-0528.2004.00228.x
Status	Published - sep 2004

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title = "Spontaneous delivery or manual removal of the placenta during caesarean section: a randomised controlled trial",

abstract = "OBJECTIVE: To compare blood loss with spontaneous delivery and manual removal of the placenta during caesarean section.DESIGN: A randomised controlled trial.SETTING: Four university hospitals between September 1999 and June 2002.POPULATION: A total of 472 women delivering by caesarean section at term were randomised to spontaneous placental delivery (n= 235) or manual removal (n= 237).METHODS: The allocation was made by opening the next available of a series of sealed opaque envelopes and derived from a computer-generated list of numbers.MAIN OUTCOME MEASURES: Significant blood loss, defined as either a drop in haemoglobin of greater than 2.5 g/dL, or the need for blood transfusion.RESULTS: The mean interval between delivery of the newborn and the placenta was longer in the spontaneous delivery group (3.4 vs 1.9 minutes), but the mean duration of the operation was similar. Significant blood loss occurred in 30 women (13%) in the spontaneous delivery group and 49 women (21%) in the manual removal one (RR 0.62; 95% CI 0.41-0.94). Post-operative fever affected 6 and 5 cases, respectively, and antibiotics were used in 14 and 12 cases, respectively.CONCLUSIONS: Allowing spontaneous delivery of the placenta reduces significant blood loss without increasing operating time.",

keywords = "Adult, Blood Transfusion/methods, Cesarean Section/methods, Female, Gestational Age, Humans, Odds Ratio, Placenta, Postoperative Hemorrhage/etiology, Pregnancy, Pregnancy Outcome, Risk Factors",

author = "Michel Morales and Gilles Ceysens and Nicole Jastrow and Caroline Viardot and Gilles Faron and Yvan Vial and Christine Kirkpatrick and Olivier Irion and Michel Boulvain",

year = "2004",

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doi = "10.1111/j.1471-0528.2004.00228.x",

language = "English",

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T1 - Spontaneous delivery or manual removal of the placenta during caesarean section

T2 - a randomised controlled trial

AU - Morales, Michel

AU - Ceysens, Gilles

AU - Jastrow, Nicole

AU - Viardot, Caroline

AU - Faron, Gilles

AU - Vial, Yvan

AU - Kirkpatrick, Christine

AU - Irion, Olivier

AU - Boulvain, Michel

PY - 2004/9

Y1 - 2004/9

N2 - OBJECTIVE: To compare blood loss with spontaneous delivery and manual removal of the placenta during caesarean section.DESIGN: A randomised controlled trial.SETTING: Four university hospitals between September 1999 and June 2002.POPULATION: A total of 472 women delivering by caesarean section at term were randomised to spontaneous placental delivery (n= 235) or manual removal (n= 237).METHODS: The allocation was made by opening the next available of a series of sealed opaque envelopes and derived from a computer-generated list of numbers.MAIN OUTCOME MEASURES: Significant blood loss, defined as either a drop in haemoglobin of greater than 2.5 g/dL, or the need for blood transfusion.RESULTS: The mean interval between delivery of the newborn and the placenta was longer in the spontaneous delivery group (3.4 vs 1.9 minutes), but the mean duration of the operation was similar. Significant blood loss occurred in 30 women (13%) in the spontaneous delivery group and 49 women (21%) in the manual removal one (RR 0.62; 95% CI 0.41-0.94). Post-operative fever affected 6 and 5 cases, respectively, and antibiotics were used in 14 and 12 cases, respectively.CONCLUSIONS: Allowing spontaneous delivery of the placenta reduces significant blood loss without increasing operating time.

AB - OBJECTIVE: To compare blood loss with spontaneous delivery and manual removal of the placenta during caesarean section.DESIGN: A randomised controlled trial.SETTING: Four university hospitals between September 1999 and June 2002.POPULATION: A total of 472 women delivering by caesarean section at term were randomised to spontaneous placental delivery (n= 235) or manual removal (n= 237).METHODS: The allocation was made by opening the next available of a series of sealed opaque envelopes and derived from a computer-generated list of numbers.MAIN OUTCOME MEASURES: Significant blood loss, defined as either a drop in haemoglobin of greater than 2.5 g/dL, or the need for blood transfusion.RESULTS: The mean interval between delivery of the newborn and the placenta was longer in the spontaneous delivery group (3.4 vs 1.9 minutes), but the mean duration of the operation was similar. Significant blood loss occurred in 30 women (13%) in the spontaneous delivery group and 49 women (21%) in the manual removal one (RR 0.62; 95% CI 0.41-0.94). Post-operative fever affected 6 and 5 cases, respectively, and antibiotics were used in 14 and 12 cases, respectively.CONCLUSIONS: Allowing spontaneous delivery of the placenta reduces significant blood loss without increasing operating time.

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KW - Blood Transfusion/methods

KW - Cesarean Section/methods

KW - Female

KW - Gestational Age

KW - Humans

KW - Odds Ratio

KW - Placenta

KW - Postoperative Hemorrhage/etiology

KW - Pregnancy

KW - Pregnancy Outcome

KW - Risk Factors

U2 - 10.1111/j.1471-0528.2004.00228.x

DO - 10.1111/j.1471-0528.2004.00228.x

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JO - British Journal of Obstetrics and Gynaecology

JF - British Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 9

ER -

Spontaneous delivery or manual removal of the placenta during caesarean section: a randomised controlled trial

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