When performing controlled cord traction, it is
important to observe some key principles in order to
avoid the potential danger of uterine inversion.
Controlled cord traction should not be attempted prior
to separation of the placenta, and should only be done in
the presence of a well-contracted uterus. While
performing cord traction, the non-dominant hand of the
practitioner should rest on the abdomen with the heel of
the hand at the symphysis pubis, and the fingertips
resting on the fundus. In addition to allowing the
practitioner to confirm that the uterus is contracted and
to guard the uterus, this hand position allows detection
of any “dipping” in the fundus, which would indicate
that the placenta is still attached and that traction should
be discontinued until separation occurs.5
When performing controlled cord traction, it isimportant to observe some key principles in order toavoid the potential danger of uterine inversion.Controlled cord traction should not be attempted priorto separation of the placenta, and should only be done inthe presence of a well-contracted uterus. Whileperforming cord traction, the non-dominant hand of thepractitioner should rest on the abdomen with the heel ofthe hand at the symphysis pubis, and the fingertipsresting on the fundus. In addition to allowing thepractitioner to confirm that the uterus is contracted andto guard the uterus, this hand position allows detectionof any “dipping” in the fundus, which would indicatethat the placenta is still attached and that traction shouldbe discontinued until separation occurs.5
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