Maternal Outcomes Following Manual Lysis of the Placenta.

NCT ID: NCT03626844

Last Updated: 2020-02-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

SUSPENDED

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-20

Study Completion Date

2020-09-30

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Third Stage of Delivery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Manual Lysis after 15 minutes (Intervention)

Manual Lysis of Placenta 15 minutes after Delivery.

Group Type EXPERIMENTAL

Manual Lysis of Placenta after 15 minutes (Intervention)

Intervention Type PROCEDURE

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.

Manual lysis after 30 minutes (Control)

Waiting 30 minutes after delivery and then manual lysis of the placenta.

Group Type ACTIVE_COMPARATOR

Manual Lysis of Placenta after 30 minutes (Control)

Intervention Type PROCEDURE

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.

Interventions

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Manual Lysis of Placenta after 15 minutes (Intervention)

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.

Intervention Type PROCEDURE

Manual Lysis of Placenta after 30 minutes (Control)

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.

Intervention Type PROCEDURE

Other Intervention Names

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Manual Lysis of Placenta after 15 minutes Manual Lysis of Placenta after 30 minutes

Eligibility Criteria

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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.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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HaEmek Medical Center, Israel

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Raed Salim, M.D.

Role: STUDY_CHAIR

Haemek Medical Center, Afula, Israel

Locations

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Haemek Medical Center

Afula, , Israel

Site Status

Countries

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Israel

References

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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.

Reference Type BACKGROUND
PMID: 19087083 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 18793876 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26555024 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 24054054 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25161458 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 15327603 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 10413231 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 23064176 (View on PubMed)

Other Identifiers

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0022-18EMC

Identifier Type: -

Identifier Source: org_study_id

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