Another small RCT (n=239) adds the element of cord
drainage to the issue of cord traction. This study
investigated the use of controlled cord traction in
combination with cord drainage and found that
compared to expectant management, the length of third
stage and amount of blood loss was significantly
reduced in the cord traction/drainage group.53 A
systematic review of trials involving placental cord
drainage as an investigated variable identified two
relevant studies. The reviewers concluded that there
appears to be potential benefit from the use of cord
drainage in terms of reducing the third stage of labour,
but more research is needed to fully investigate its
impact.54 This practice is not typically included as a
component of active management.
Overall the evidence shows that controlled cord traction
results in a statistically significant decrease in the
incidence of PPH. Further investigation into the role of
controlled cord traction from larger trials with
comparable study groups would be useful.