Placental drainage of fetal blood at cesarean delivery and feto maternal transfusion: a randomized controlled trial.
OBJECTIVE
To assess the efficacy of placental drainage of fetal blood at the time of cesarean delivery on the incidence of feto-maternal transfusion.


METHODS
This randomized trial includes 86 gravid women who underwent cesarean delivery. Forty-four women were assigned to the placental drainage group and 42 to the no-drainage group. Placental drainage was accomplished by cutting and milking the umbilical cord until no further blood flow occurred. All placentas were spontaneously expelled. The primary outcome variable, as assessed by preoperative and postoperative Kleihauer-Betke tests, was the amount of fetal blood (greater than or equal to 0.5 mL) in the maternal circulation.


RESULTS
The group having placental drainage of fetal blood before placental delivery showed a significantly lower incidence (3 of 44, 6.8%) of feto-maternal transfusion (P=.003) as compared with the undrained group (14 of 42, 33%; relative risk 0.20, 95% confidence interval 0.065-0.65; number needed to treat=4).


CONCLUSIONS
Placental drainage of fetal blood before spontaneous placental delivery at the time of cesarean delivery significantly reduces the incidence of feto-maternal transfusion.


BACKGROUND
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00470899


METHODS
I.
Leavitt
Benjamin G
BG
Cox Family Medicine Residency, Cox Health System, Springfield, Missouri 65809, USA.
Huff
Deborah L
DL
Bell
Laird A
LA
Thurnau
Gary R
GR
D000293:Adolescent; D000328:Adult; D001787:Blood Group Incompatibility / Q000503:physiopathology; D002585:Cesarean Section / Q000379:methods*; D004322:Drainage; D005260:Female; D005312:Fetal Blood / Q000276:immunology*; D005331:Fetomaternal Transfusion / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008431:Maternal-Fetal Exchange; D010920:Placenta / Q000098:blood supply / Q000601:surgery; D011247:Pregnancy; D012307:Risk Factors; D014470:Umbilical Cord / Q000098:blood supply / Q000601:surgery