The Effectiveness of Placental Drainage in the Active Management of the Third Stage against the Duration of Three Childbirths in the Independent Practice of Midwives in Banda Aceh City

Gustiana Gustiana; Novemi Novemi; Yusnaini Yusnaini; Kartinazahri Kartinazahri; Iin Fitraniar

doi:10.3889/oamjms.2021.6461

Authors

Gustiana Gustiana Department of Midwifery, Polytechnic of Health, Ministry of Health, Aceh, Indonesia
Novemi Novemi Department of Midwifery, Polytechnic of Health, Ministry of Health, Aceh, Indonesia
Yusnaini Yusnaini Department of Midwifery, Polytechnic of Health, Ministry of Health, Aceh, Indonesia
Kartinazahri Kartinazahri Department of Midwifery, Polytechnic of Health, Ministry of Health, Aceh, Indonesia
Iin Fitraniar Department of Midwifery, Polytechnic of Health, Ministry of Health, Aceh, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6461

Keywords:

Placental drainage, Active management, Childbirths

Abstract

BACKGROUND: The third stage of active management has become a standard practice in delivery management. Implementation of childbirth care requires accelerated release of the placenta to avoid bleeding. Placental drainage can shorten the duration of the three stages and reduce blood loss during labor.

AIM: The aim of the study is to analyzing the effectiveness of placental drainage in the third stage active management of the third stage of delivery at the midwife’s independent practice (PMB) in the city of Banda Aceh.

METHODS: This study used a Quasi Experiment design with a post-test control design. This research was carried out for 12 weeks at the PMB in Banda Aceh City, namely mothers who gave birth at the Erni Munir PMB and the Independent Practice Midwife Mutia Yacob. The sampling technique was purposive sampling. The sample in this study amounted to thirty mothers giving birth, divided into two groups, namely, the treatment group with placental drainage as many as 15 mothers and respondents with cord clamping as many as 15 mothers. With the inclusion criteria, the mother is willing to be a respondent, the vital signs of normal mothers, single and live fetuses, term pregnancy, and an interpretation of average fetal weight ≥ 2500 g. Data analysis used the MannWhitney test, with a confidence level of 95%.

RESULTS: The results showed a difference in effectiveness between the placental drainage group and the umbilical cord clamping group, as evidenced by a statistical test with p = 0.001. The length of three stages required by mothers to give birth with placental drainage has a mean value of 4.47 min with a standard deviation of 0.516. The average length of time required by the mother to give birth with umbilical cord clamping is 5.40 min with a standard deviation value of 0.828.

CONCLUSION: Placental drainage was more effective than umbilical cord clamping to shorten the third stage length in the Independent Practice of Midwives in Banda Aceh City.

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References

Nababan HY, Hasan M, Marthias T, Dhital R, Rahman A, Anwar I. Trends and inequities in use of maternal health care services in Indonesia, 1986-2012. Int J Womens Health. 2019;10:11-24. https://doi.org/10.2147/ijwh.s144828 PMid:29343991 DOI: https://doi.org/10.2147/IJWH.S144828

World Health Organization. Trends in Maternal Mortality: 1990 to 2013 Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. Geneva: World Health Organization; 2013. https://doi.org/10.1111/padr.12033 DOI: https://doi.org/10.1111/padr.12033

Statistics Indonesia (Badan Pusat Statistik-BPS). Profil Penduduk Indonesia Hasil SUPAS. Jakarta: Badan Pusat Stastistik; 2015.

Sumarmi S. Socio-ecological model of health behavior and continuum of care approach to reduce maternal mortality. Indonesia J Public Health. 2017;12(1):129-41. https://doi.org/10.20473/ijph.v12i1.2017.129-141 DOI: https://doi.org/10.20473/ijph.v12i1.2017.129-141

World Health Organization. WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage. Geneva: World Health Organization; 2012.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: A WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-33. https://doi.org/10.1016/s2214-109x(14)70227-x PMid:25103301 DOI: https://doi.org/10.1016/S2214-109X(14)70227-X

Li XF, Fortney JA, Kotelchuck M, Glover LH. The postpartum period: The key to maternal mortality. Int J Gynaecol Obstet. 1996;54(1):1-10. https://doi.org/10.1016/0020-7292(96)02667-7 PMid:8842811 DOI: https://doi.org/10.1016/0020-7292(96)02667-7

Goldenberg RL, McClure EM. Maternal, fetal and neonatal mortality: Lessons learned from historical changes in high income countries and their potential application to low-income countries. Matern Health Neonatol Perinatol. 2015;1:3. https://doi.org/10.1186/s40748-014-0004-z PMid:27057321 DOI: https://doi.org/10.1186/s40748-014-0004-z

Chowdhury ME, Botlero R, Koblinsky M, Saha SK, Dieltiens G, Ronsmans C. Determinants of reduction in maternal mortality in Matlab, Bangladesh: A 30-year cohort study. Lancet. 2007;370(9595):1320-8. https://doi.org/10.1016/s0140-6736(07)61573-6 PMid:17933646 DOI: https://doi.org/10.1016/S0140-6736(07)61573-6

Wood J, Rogers J. The third stage of labour In: Alexander J, Levy V, Roth C, editors. Midwifery Practice: Core Topics 2. London: MacMillan Press Ltd.; 1997. https://doi.org/10.1007/978-1-349-14529-4_8 DOI: https://doi.org/10.1007/978-1-349-14529-4_8

Afzal MB, Bushra N, Waheed K, Sarwar A, Awan NU. Role of placental blood drainage as a part of active management of third stage of labour after spontaneous vaginal delivery. J Pak Med Assoc. 2019;69(12):1790-3. https://doi.org/10.5455/jpma.302642458 PMid:31853104 DOI: https://doi.org/10.5455/JPMA.302642458

Roy P, Sujatha MS, Bhandiwad A, Biswas B, Chatterjee A. Placental blood drainage as a part of active management of third stage of labour after spontaneous vaginal delivery. J Obstet Gynaecol India. 2016;66 Suppl 1:242-5. https://doi.org/10.1007/s13224-016-0857-3 PMid:27651611 DOI: https://doi.org/10.1007/s13224-016-0857-3

Jangsten E, Mattsson LÅ, Lyckestam I, Hellström AL, Berg M. A comparison of active management and expectant management of the third stage of labour: A Swedish randomised controlled trial. BJOG. 2011;118(3):362-9. https://doi.org/10.1111/j.1471-0528.2010.02800.x PMid:21134105 DOI: https://doi.org/10.1111/j.1471-0528.2010.02800.x

Soltani H, Poulose TA, Hutchon DR. Placental cord drainage after vaginal delivery as part of the management of the third stage of labour. Cochrane Database Syst Rev. 2011;7(9):CD004665. https://doi.org/10.1002/14651858.cd004665.pub3 PMid:21901693 DOI: https://doi.org/10.1002/14651858.CD004665.pub3

Jongkolsiri P, Manotaya S. Placental cord drainage and the effect on the duration of third stage labour, a randomized controlled trial. J Med Assoc Thai. 2009;92(4):457-60. PMid:19374293

Wu HL, Chen XW, Wang P, Wang QM. Effects of placental cord drainage in the third stage of labour: A metaanalysis. Sci Rep. 2017;7(1):7067. https://doi.org/10.1038/s41598-017-07722-7 PMid:28765609 DOI: https://doi.org/10.1038/s41598-017-07722-7

Leavitt BG, Huff DL, Bell LA, Thurnau GR. Placental drainage of fetal blood at cesarean delivery and feto maternal transfusion: A randomized controlled trial. Obstet Gynecol. 2007;110(3):608-11. https://doi.org/10.1097/01.aog.0000277262.80793.0d PMid:17766607 DOI: https://doi.org/10.1097/01.AOG.0000277262.80793.0d

Sharma JB, Pundir P, Malhotra M, Arora R. Evaluation of placental drainage as a method of placental delivery in vaginal deliveries. Arch Gynecol Obstet. 2005;271(4):343-5. https://doi.org/10.1007/s00404-004-0619-9 PMid:15034720 DOI: https://doi.org/10.1007/s00404-004-0619-9

Begley CM, Gyte GM, Devane D, McGuire W, Weeks A. Active versus expectant management for women in the third stage of labour. Cochrane Database Syst Rev. 2011;11:CD007412. https://doi.org/10.1002/14651858.cd007412.pub3 PMid:22071837 DOI: https://doi.org/10.1002/14651858.CD007412.pub3