Related Experiment Video
Updated: May 22, 2026
Ex Vivo Perfusion of the Rodent Placenta
Published on: May 30, 2019
Reducing hemodynamic compromise with placental removal at 10 versus 15 minutes: a randomized clinical trial
Everett F Magann1, Amy Niederhauser, Dorota A Doherty
1Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA. efmagann@uams.edu
Objective:
To determine if hemodynamic compromise can be reduced with manual placental removal at 10 compared with 15 minutes.
Study Design:
Singleton pregnancies admitted for delivery with no contraindication to a vaginal delivery were randomized to a 10-minute group (placentas manually removed if not spontaneously delivered by 10 minutes) versus a 15-minute group. The primary outcome, hemodynamic compromise, was defined as: blood loss exceeding 1000 mL and/or circulatory instability (inability to maintain blood pressure/pulse secondary to acute blood loss) and/or drop in hematocrit of ≥10 percentage points.
Results:
From July 2006 to July 2010, 156 women were randomized into the 10-minute group and 156 in the 15-minute group. Women in the 15-minute group had a greater likelihood of hemodynamic compromise univariately (19.2% versus 6.4%, p = 0.001) and after adjustments for ethnicity, induction rate, duration of second stage of labor, and nulliparity (relative risk 3.03, 95% confidence interval 1.52 to 5.47, p = 0.002).
Conclusion:
Hemodynamic compromise is decreased with manual placental removal within 10 minutes of delivery compared with 15 minutes.
