The aim of this study was to estimate the best time interval needed to start delivering the placenta following fetal delivery in cesarean section (CS) that allows placental delivery with decreased incidence of undue morbidity.
Patients and methods
This prospective study was conducted on patients attending the Labor Ward, Cairo University Hospital (Egypt). A total of 120 pregnant women who had an indication for elective or emergency CS were studied between October 2009 and May 2010. Women admitted for CS were randomly assigned to one of the four study groups: group A, group B, group C, and group D. The patients were assigned according to the time before beginning cord traction to deliver the placenta after fetal delivery (15, 30, 45, and 60 s, respectively). The primary outcome was the time taken for the placenta to separate, and the secondary outcome measured the morbidity during placental separation.
In this study, we found that women who had traction on their placentas after 60 s (group D) had the best results in the amount of blood loss from the placental bed (125.36±7.96 ml, n=30), as well as the least time interval for complete delivery of the placenta (24.7±4.41 s, n=30), with less complications (16%, n=30).
This study suggests that waiting for 1 min after delivery of the fetus before starting cord traction could help in reducing the amount of blood loss from the placental bed. Moreover, this reduces the time interval needed for placental separation after starting cord traction.