Cervical Traction vs. Active Management of 3rd Stage of Labor
Status:
Recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
306 patients will be divided randomly in to 2 GROUPS:
- control group: 153 patients will receive Oxytocin 10 IU I.V shot administered at the
time of delivery of the anterior shoulder of the baby for both groups in prevention of
postpartum haemorrhage,followed by active management of the third stage of labor by
administration of oxytocin 5 IU units IM and waiting for signs of placental separation
then controlled cord traction (CCT) to the umbilical cord while applying simultaneous
counter-pressure to the uterus, through the abdomen(Brandt Andrews maneuver)
- study group:156 patients received Oxytocin 10 IU I.V shot at the time of delivery of the
of the anterior shoulder of the baby according to the WHO recommendation .Then oxytocin
is stopped and cervical traction (Amr maneuver )is applied.
In the maneuver,sustained traction downward and posteriorly was applied to anterior and
posterior lips of the cervix using ovum forceps for approximately 90 seconds. The traction
should be adequate to allow the cervix to reach the vaginal introitus. Meanwhile (CCT ) is
avoided and watchful waiting for signs of placental separartion till 90 seconds end. Massage
is not employed but the fundus is frequently palpaple to insure it doesnot become atonic and
filled with blood from placenta separation. In cases whom placental separation did not occur
within the 90 seconds, we removed the ovum forceps and waited for 30 min for the placental
separation .