The Effect of Skin-to-skin Contact on Placental Separation Time, Type, Postpartum Hemorrhage and Comfort

Study Overview
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Brief Summary
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It is aimed to determine the late cord clamping with early skin-to-skin contact in primiparous pregnant women who delivered vaginally, according to placental separation time, separation method, amount of postpartum bleeding and postpartum comfort.

Detailed Description
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The research is an experimental type randomized controlled trial. The data of the research gathered in the delivery room clinic of Erzurum City Hospital affiliated to the Ministry of Health in Erzurum city center between 02.11.2022 and 10.06.2023. The study was completed with 126 primiparous pregnants, 63 of whom were controls and 63 of whom were experimental, randomized in the clinic. Personal Information Form and Postpartum Comfort Scale prepared by the researcher were used to collect the data of the study. control group Pregnant women who met the criteria for admission to the delivery room were selected, the institution's routine policies were implemented. The mother was informed about the study and written consent was obtained. Hospital routine practices continued until birth. The stopwatch is started the moment the baby is born. After birth, the umbilical cord was clamped immediately without skin-to-skin contact between the mother and the baby, and the baby was taken to routine care. Signs of placental separation were monitored with a stopwatch, and it was noted at what minute the symptoms were seen. Placental delivery time and separation type were noted in the relevant part of the form. According to the routines taken from each hospitalized patient in institutional policies, the volunteer's entry hemoglobin and hematocrit values were noted on the form. The Personal Information Form consisting of 22 questions and the Postpartum Comfort scale were administered to the mother at the end of the follow-up period in the delivery room (2 hours later). From the 6th hour blood values found in the hospital routine, the mother's hemoglobin and hematocrit values were noted on the form. Experimental group Pregnant women who met the criteria for admission to the delivery room were selected, the institution's routine policies were implemented. The mother was informed about the study and written consent was obtained. Hospital routine practices continued until birth. The stopwatch is started the moment the baby is born. The baby was placed on the mother's chest, it was waited for 60-90 seconds in skin-to-skin contact, and breastfeeding was tried. At the end of the period, the umbilical cord was clamped and the baby was placed under a radiant heater and routine care was continued. Signs of placental separation were monitored with a stopwatch, and it was noted at what minute the symptoms were seen. Placental delivery time and separation type were noted in the relevant part of the form. According to the routines taken from each hospitalized patient in institutional policies, the volunteer's entry hemoglobin and hematocrit values were noted on the form. During the repair of episiotomy or desuria, if any, in the mother, skin-to-skin contact was made between the baby and the mother for 1 hour without disrupting the procedures. The Personal Information Form consisting of 22 questions and the Postpartum Comfort scale were administered to the mother at the end of the follow-up period in the delivery room (2 hours later). From the 6th hour blood values found in the hospital routine, the mother's hemoglobin and hematocrit values were noted on the form.

Official Title
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The Effect of Skin-to-Skin Contact and Delayed Cord Clampingon Placental Separation Time, Separation Method, Amount of Postpartum Bleeding and Postpartum Comfort

Conditions
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Patient Comfort, Postpartum Hemorrhage, Midwifery, Placenta

Intervention / Treatment
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* Other: skin-to-skin contact and delayed cord clamping
* Other: avoiding skin-to-skin contact and early cord clamping


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: for pregnant women Those who agreed to participate in the research 18-49 years old Firstborn (nulliparous) Have 37-42 weeks of pregnancy The baby in head presentation No prenatal risk pregnancy No risk during and after birth for newborns Absence of any health problems or congenital diseases, No need for resuscitation after birth. APGAR score of 8 points or more Exclusion Criteria: Births less than 37 weeks Multiparity Any complications in the mother or baby Removal of the placenta by intervention rather than spontaneous separation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 49 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: the group with skin-to-skin contact and delayed cord clamping<br>In this arm, skin-to-skin contact and delayed cord clamping are performed between mother and baby. | Other: skin-to-skin contact and delayed cord clamping<br>* Placental separation time, separation method, amount of postpartum bleeding and postpartum comfort were evaluated with skin-to-skin contact and late cord clamping after delivery.<br>|
| Experimental: The group without skin-to-skin contact and early cord clamping<br>In this arm, skin-to-skin contact and delayed cord clamping are not performed between mother and baby. | Other: avoiding skin-to-skin contact and early cord clamping<br>* After delivery, placental separation time, separation method, amount of postpartum bleeding and postpartum comfort were evaluated without skin-to-skin contact and late cord clamping.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Skin-to-skin contact and delayed cord clamping affect placental separation time. | It shortens the placental separation time in women who have had a vaginal delivery with skin-to-skin contact and delayed clamping of the cord. | 0-30 minute | 
| Skin-to-skin contact and delayed cord clamping affect the amount of postpartum bleeding. | Skin-to-skin contact and delayed cord clamping reduce the amount of postpartum hemorrhage in women who deliver vaginally. | 0-6 hours | 
| Skin-to-skin contact and delayed cord clamping have no effect on the type of placental separation. | Determination of the effect of skin-to-skin contact and delayed cord clamping on the type of placental separation. | 0-30 minute | 
| Skin-to-skin contact and delayed cord clamping affect the level of postpartum comfort. | Increasing the postpartum comfort level of women who had vaginal delivery with skin-to-skin contact and delayed cord clamping. | 2 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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skin-to-skin contact, placental separation time, Postpartum Comfort, placental separation method, delayed clamping of the umbilical cord, midwife