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pandora necklaces This standard placental expulsion is the usual management in France, as taught in university hospitals and midwifery schools, and it was the routine procedure in the five participating centres before the trial.All other aspects of management of the third stage were identical in both arms: intravenous injection of 5 IU oxytocin and clamping and cutting of the cord within two minutes of birth; placement of a graduated (100 mL graduation) collector bag (MVF Merivaara France) just after birth, left in place until the birth attendant judged that bleeding had stopped and that there was no reason to monitor further,24 and always at least for 15 minutes; and manual removal of the placenta at 30 minutes after birth if not expelled. A blood sample was taken from all women on the second day after delivery to measure haemoglobin level and haematocrit.OutcomesThe primary outcome of the trial was the incidence of postpartum haemorrhage, defined by a blood loss of 500 mL, measured with a graduated collector bag.25 The main secondary outcomes were other objective measures of postpartum bleeding: measured blood loss 1000 mL at bag removal, mean measured blood loss at 15 minutes after birth (the bag had to be left in place at least 15 minutes to have one measure of blood loss at the same time point in all women), mean measured postpartum blood loss at bag removal pandora charms, and mean changes in peripartum haemoglobin level and haematocrit (difference between haemoglobin level and haematocrit before delivery and at day 2 postpartum). Other secondary outcomes included use of supplementary uterotonic treatment; postpartum transfusion (until discharge); arterial embolisation or emergency surgery for postpartum haemorrhage; other characteristics of the third stage, including duration, manual removal of the placenta; and women’s experience of the third stage, assessed by a self administered questionnaire on day 2 postpartum pandora necklaces.
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