A pilot randomized controlled trial of controlled cord traction to reduce postpartum blood loss

Int J Gynaecol Obstet. 2009 Oct;107(1):4-7. doi: 10.1016/j.ijgo.2009.05.021. Epub 2009 Jun 21.


Objective: To evaluate whether controlled cord traction (CCT) for management of the third stage of labor reduced postpartum blood loss compared with a "hands-off" management protocol.

Methods: Women with imminent vaginal delivery were randomly assigned to either a CCT group or a hands-off group. The women received prophylactic oxytocin. The primary outcome was blood loss during the third stage of labor.

Results: In total, 103 women were allocated to the CCT group and 101 were allocated to the hands-off group. Median blood loss in the CCT group and the hands-off group was 282.0 mL and 310.2 mL, respectively. The difference in blood loss (-28.2 mL) was not significant (95% confidence interval, -92.3 to 35.9; P=0.126). Blood collection in the hands-off group took 1.2 minutes longer than in the CCT group, which may have contributed to this difference.

Conclusion: CCT may reduce postpartum blood loss. The present findings support conducting a large trial to determine whether CCT can prevent postpartum hemorrhage.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Delivery, Obstetric / methods
  • Female
  • Humans
  • Labor Stage, Third*
  • Maternal Mortality
  • Oxytocics / therapeutic use
  • Oxytocin / therapeutic use
  • Pilot Projects
  • Postpartum Hemorrhage / prevention & control*
  • Pregnancy
  • Time Factors
  • Traction / methods
  • Umbilical Cord*
  • Young Adult


  • Oxytocics
  • Oxytocin