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Int J Gynaecol Obstet. 2009 Oct;107(1):4-7. doi: 10.1016/j.ijgo.2009.05.021. Epub 2009 Jun 21.

A pilot randomized controlled trial of controlled cord traction to reduce postpartum blood loss.

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  • 1Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.



To evaluate whether controlled cord traction (CCT) for management of the third stage of labor reduced postpartum blood loss compared with a "hands-off" management protocol.


Women with imminent vaginal delivery were randomly assigned to either a CCT group or a hands-off group. The women received prophylactic oxytocin. The primary outcome was blood loss during the third stage of labor.


In total, 103 women were allocated to the CCT group and 101 were allocated to the hands-off group. Median blood loss in the CCT group and the hands-off group was 282.0 mL and 310.2 mL, respectively. The difference in blood loss (-28.2 mL) was not significant (95% confidence interval, -92.3 to 35.9; P=0.126). Blood collection in the hands-off group took 1.2 minutes longer than in the CCT group, which may have contributed to this difference.


CCT may reduce postpartum blood loss. The present findings support conducting a large trial to determine whether CCT can prevent postpartum hemorrhage.

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