Umbilical Cord Drainage to Prevent Postpartum Hemorrhage

This is a single-blind, parallel-group, superiority efficacy clinical trial. The intervention involves passive drainage of blood from the umbilical cord immediately after cord clamping and cutting, allowing it to flow into a calibrated drape. The control group receives standard active management of the third stage of labor without cord drainage. The primary objective is to compare postpartum blood loss between the groups. Secondary objectives include comparing pre- and postpartum hemoglobin levels, the need for additional therapeutic interventions (uterotonics, uterine revision, transfusion), incidence of adverse events related to cord management, and maternal satisfaction using the Birth Satisfaction Scale. The study plans to enroll 400 participants (200 per group) over approximately 6 months at a single center.

Inclusion criteria

• Pregnant women aged 18-49 years.
• Singleton pregnancy.
• Gestational age ≥37 weeks.
• active labor with cephalic presentation.
• Planned for vaginal delivery.
• Capable of providing informed consent.

Exclusion criteria

• Planned or emergent cesarean section.
• Instrumental delivery (e.g., forceps, vacuum).
• Antepartum hemorrhage.
• Severe anemia (Hemoglobin <8 g/dL) or specific hematological disorders (e.g., sickle cell disease, thalassemia, hemophilia, thrombocytopenia <100,000/µL).
• Use of anticoagulant medication.
• Non-cephalic fetal presentation (e.g., breech, transverse).
• Refusal to participate or inability to provide informed consent.