Document Detail


A randomised controlled trial of placental cord drainage to reduce feto-maternal transfusion.
MedLine Citation:
PMID:  20018421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether placental drainage via the umbilical cord prior to placental delivery reduces the size of feto-maternal transfusion and thus the chance of rhesus isoimmunisation in rhesus negative women. STUDY DESIGN: A randomised controlled trial conducted in a tertiary hospital setting in the UK compared 18 rhesus negative women who had placental drainage (10 caesarean section and 8 vaginal deliveries) with 18 rhesus negative women where the cord remained clamped until placental delivery (8 caesarean section and 10 vaginal deliveries). Maternal venous blood samples were taken before delivery and at a mean of 142 min after delivery of the placenta, and analysed using flow cytometry to calculate the size of the feto-maternal transfusion. The statistical analysis was performed using SPSS Version 13 statistical software. The main outcome measure was the quantification of the volume of fetal cells in the maternal circulation before and after delivery. RESULTS: In the 72 specimens taken, 40 demonstrated measurable amounts of fetal cells in the maternal circulation. In the 18 women who had placental drainage, the mean (SD) size of the feto-maternal transfusion was 0.50 ml (0.79) before and 0.39 ml (0.58) after delivery. In the 18 women who had a clamped cord, the mean (SD) feto-maternal transfusion was 0.46 ml (0.84) before and 0.78 ml (1.1) after delivery. There was no significant difference between the net feto-maternal transfusions in the two groups (Mann-Whitney U 122.5, p 0.19). CONCLUSION: Placental drainage does not reduce the amount of feto-maternal transfusion and this method of placental delivery is not recommended to reduce feto-maternal transfusion.
Authors:
R Navaneethakrishnan; A Anderson; S Holding; C Atkinson; S W Lindow
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-12-16
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  149     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-05-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  27-30     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Obstetrics and Gynaecology, Hull and East Yorkshire Women and Children's Hospital, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, East Yorkshire, UK. rajikrishnan@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Delivery, Obstetric / methods*
Female
Fetomaternal Transfusion / immunology,  prevention & control*
Flow Cytometry
Humans
Pilot Projects
Placenta / blood supply,  immunology
Pregnancy
Rh Isoimmunization / immunology,  prevention & control*
Statistics, Nonparametric
Treatment Outcome
Umbilical Cord / blood supply,  immunology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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