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Trial registered on ANZCTR
Registration number
ACTRN12621000916842
Ethics application status
Approved
Date submitted
8/06/2021
Date registered
15/07/2021
Date last updated
23/05/2023
Date data sharing statement initially provided
15/07/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Placental Cord Drainage versus Delayed Cord Clamping at Elective Caesarean Section
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Scientific title
Time to Delivery of Placenta in Placental Cord Drainage versus Delayed Cord Clamping at Elective Caesarean Section: a Randomised-Controlled Trial
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Secondary ID [1]
304428
0
Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Placental Delivery
322242
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Postpartum Haemorrhage
322243
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Condition category
Condition code
Reproductive Health and Childbirth
319934
319934
0
0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Placental Cord Drainage
- ie. immediate clamping and cutting of the placental cord at caesarean section, followed by drainage of the placental side of the cord into a receptacle).
- this will be performed by the operating surgeon (ie. Consultant Obstetrician or Obstetrics Registrar)
- this is a once-off procedure, at the time of elective caesarean section
- this will occur in theatre at an urban hospital, with Obstetrics services
- adherence to the intervention/control will be documented at the time of caesarean, and rationale for deviation will be documented. If not documented at the time, patient medical record will be consulted by study team to determine a possible rationale.
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Intervention code [1]
320781
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Treatment: Surgery
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Comparator / control treatment
Delayed Cord Clamping
- ie. clamping and cutting of the placental cord after at least 60 seconds to allow possible perfusion of blood from placenta to neonate
- this will be performed by the operating surgeon (ie. Consultant Obstetrician or Obstetrics Registrar)
- this is a once-off procedure, at the time of elective caesarean section
- this will occur in theatre at an urban hospital, with Obstetrics services
- adherence to the intervention/control will be documented at the time of caesarean, and rationale for deviation will be documented. If not documented at the time, patient medical record will be consulted by study team to determine a possible rationale.
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Control group
Active
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Outcomes
Primary outcome [1]
327802
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Time to delivery of placenta
From Data Collection Form and Patient Medical Record
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Assessment method [1]
327802
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Timepoint [1]
327802
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At time of delivery of placenta
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Secondary outcome [1]
396646
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Estimated Blood Loss
From Patient Medical Record
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Assessment method [1]
396646
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Timepoint [1]
396646
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At End of Caesarean Section
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Secondary outcome [2]
396647
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Change in maternal haemoglobin
From Patient Medical Record
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Assessment method [2]
396647
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Timepoint [2]
396647
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Measured 12-36 hours post-operatively (ie. Day 1 Postoperative).
Compared to haemoglobin taken within 72 hours before surgery.
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Secondary outcome [3]
396648
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Proportion of patients with Postpartum Haemorrhage
From Patient Medical Record
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Assessment method [3]
396648
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Timepoint [3]
396648
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At the conclusion of study
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Secondary outcome [4]
396649
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Oxytocic medications administered by Anaesthetics
From Patient Medical Record
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Assessment method [4]
396649
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Timepoint [4]
396649
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At end of Caesarean section
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Secondary outcome [5]
396650
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Proportion of patients receiving blood transfusion
From Patient Medical Record
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Assessment method [5]
396650
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Timepoint [5]
396650
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At the conclusion of study
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Secondary outcome [6]
396651
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Proportion of patients requiring Manual Removal of Placenta at Caesarean Section
From Patient Medical Record
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Assessment method [6]
396651
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Timepoint [6]
396651
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At the conclusion of study
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Secondary outcome [7]
396652
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Deviation from Study Protocol or Abandoning Intervention/Control
From Data Collection Form and Patient Medical Record
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Assessment method [7]
396652
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Timepoint [7]
396652
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At end of Caesarean section
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Eligibility
Key inclusion criteria
Elective Caesarean Section
Singleton Pregnancy
Cephalic Presentation
Gestation 37+0 to 41+6
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Placenta praevia on most recent ultrasound
• Suspected placenta accreta spectrum
• Suspected intrauterine growth restriction
• Oligohydramnios on most recent ultrasound
• Fetal Death in Utero
• Suspected Placental Abruption
• Known fetal anatomical abnormality
• Abnormal fetal dopplers of most recent ultrasound
• Preterm delivery
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using online Random Number Generator
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Cochrane review demonstrated a >40% reduction in time to delivery of placenta at vaginal delivery. Studies have suggested approximately 200 seconds for delivery of placenta at caesarean section. Using a conservative 180 seconds +/- 90 seconds as the baseline time of delivery of placenta at caesarean section, and a conservative 33% reduction (60 seconds), the required power is 35 patients per group.
Using 50 patients per group to allow for uncertainty translating Cochrane findings at vaginal delivery to caesarean section.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
19/07/2021
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Actual
11/10/2021
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Date of last participant enrolment
Anticipated
30/06/2022
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Actual
4/05/2023
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Date of last data collection
Anticipated
29/07/2022
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Actual
11/05/2023
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Sample size
Target
100
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Accrual to date
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Final
100
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
19668
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Box Hill Hospital - Box Hill
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Recruitment hospital [2]
19669
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Angliss Hospital - Upper Ferntree Gully
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Recruitment postcode(s) [1]
34301
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3128 - Box Hill
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Recruitment postcode(s) [2]
34302
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3156 - Upper Ferntree Gully
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Funding & Sponsors
Funding source category [1]
308792
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Hospital
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Name [1]
308792
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Eastern Health
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Address [1]
308792
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8 Arnold St
Box Hill
VIC 3128
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Country [1]
308792
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Australia
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Primary sponsor type
Individual
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Name
Michael Fahy
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Address
Eastern Health
8 Arnold St
Box Hill
VIC 3128
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Country
Australia
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Secondary sponsor category [1]
309708
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None
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Name [1]
309708
0
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Address [1]
309708
0
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Country [1]
309708
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308704
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Eastern Health Office of Research and Ethics
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Ethics committee address [1]
308704
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Eastern Health 8 Arnold St Box Hill VIC 3128
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Ethics committee country [1]
308704
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Australia
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Date submitted for ethics approval [1]
308704
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01/06/2021
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Approval date [1]
308704
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04/10/2021
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Ethics approval number [1]
308704
0
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Summary
Brief summary
Placental delivery is accelerated by placental cord drainage at vaginal delivery. Hypothesis: This effect may extrapolate to caesarean section, where the blood loss from the vascular uterine incision may make time to delivery of placenta particularly important. Aim: To determine if drainage of the placental cord at caesarean section accelerates delivery of the placenta, compared to delayed clamping of the placental cord. Methods: Randomised Controlled Trial with Intention to Treat Analysis. Women at elective caesarean section without antenatal evidence of placental disease or fetal compromise, randomised to Intervention (Placental Cord Drainage) or Control (Delayed Cord Clamping).
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
111622
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Dr Michael Fahy
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Address
111622
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Eastern Health,
8 Arnold St,
Box Hill,
VIC 3128
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Country
111622
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Australia
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Phone
111622
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+61 3 8396 8349
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Fax
111622
0
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Email
111622
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[email protected]
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Contact person for public queries
Name
111623
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Michael Fahy
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Address
111623
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Eastern Health,
8 Arnold St,
Box Hill,
VIC 3128
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Country
111623
0
Australia
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Phone
111623
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+61 3 8396 8349
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Fax
111623
0
Query!
Email
111623
0
[email protected]
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Contact person for scientific queries
Name
111624
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Michael Fahy
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Address
111624
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Eastern Health,
8 Arnold St,
Box Hill,
VIC 3128
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Country
111624
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Australia
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Phone
111624
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+61 3 8396 8349
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Fax
111624
0
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Email
111624
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Any shared data will be de-identified.
All of the individual participant data collected during the trial, after de-identification.
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When will data be available (start and end dates)?
Immediately following publication, no end date
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Available to whom?
only researchers who provide a methodologically sound proposal
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Available for what types of analyses?
for IPD meta-analyses
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How or where can data be obtained?
access subject to approvals by Principal Investigator (
[email protected]
)
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
11940
Study protocol
[email protected]
11942
Informed consent form
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF