scholarly journals Delayed Umbilical Cord Clamping at <32 Weeks' Gestation: Implementation and Outcomes

2017 ◽  
Vol 34 (11) ◽  
pp. 1048-1053
Author(s):  
Tatiana Bierut ◽  
Shayna Conner ◽  
Methodius Tuuli ◽  
Zachary Vesoulis ◽  
George Macones ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Gases ◽  
Maternal Outcomes ◽  
Blood Gas ◽  
Cord Clamping ◽  
Significant Difference ◽  
Umbilical Cord Clamping ◽  
The Impact

Objectives This study aims to evaluate the implementation of a delayed umbilical cord clamping (DCC) protocol for neonates <32 weeks. Secondarily, to evaluate the impact of DCC on maternal outcomes and on the ability to obtain umbilical cord blood gases. Study Design Retrospective cohort study from November 2014 to March 2016 of patients delivered by 316/7 weeks. In 2014, an institutional protocol for DCC at <32 weeks was implemented. We assessed adherence to the protocol and compared adverse maternal outcomes (utilizing a hemorrhage composite). We evaluated the impact of DCC on the ability to obtain adequate umbilical cord blood gas specimens. Results Of the 185 patients included in the study, 90 underwent DCC, and 72% of potentially eligible patients appropriately received DCC. There was no significant difference in the maternal hemorrhage composite outcome between DCC and immediate cord clamping (23.3 vs. 36.8%, adjusted odds ratio = 0.64, 95% confidence interval = 0.33, 1.26). There was also no significant difference in the ability to obtain a single or paired umbilical cord blood gas result. Conclusion Implementation of a DCC protocol for preterm neonates is feasible and was successful. We did not find an increase in maternal risk or a decrease in the ability to obtain umbilical cord blood gases following DCC.

Implementation and Outcomes of Universal Delayed Umbilical Cord Clamping at Term

2018 ◽  
Vol 36 (03) ◽  
pp. 233-242 ◽  
Author(s):  
Victoria Wesevich ◽  
Methodius Tuuli ◽  
George Macones ◽  
Alison Cahill ◽  
Janine Rhoades
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Gases ◽  
Adjusted Relative Risk ◽  
Blood Gas ◽  
Cord Clamping ◽  
Increased Risk ◽  
Significant Difference ◽  
Umbilical Cord Clamping

Objective To evaluate the implementation of an institutional protocol for universal delayed umbilical cord clamping (DCC) at term on maternal, neonatal, and umbilical cord blood gas outcomes. Study Design This is a retrospective cohort study of singleton term gestations from April through July 2017. On June 1, 2017, a protocol was implemented for DCC in all deliveries. Outcomes were compared between patients delivered prior to and those delivered after implementation. The primary outcome was postpartum hemorrhage (PPH). Secondary outcomes were additional adverse maternal, neonatal, and umbilical cord blood gas outcomes. Multivariable logistic regression was used to adjust for potential confounders. Results Of 682 patients, 341 were delivered preprotocol and 341 were delivered postprotocol. After implementation, there was 91.8% adherence to the protocol. Overall, there was no significant difference in PPH between patients delivered preprotocol and those delivered postprotocol (8.2 vs. 13.2%; adjusted relative risk [aRR]: 1.26, 95% confidence interval [CI]: 0.98–1.51). There was a significant decrease in the ability to obtain paired arterial and venous umbilical cord blood gases from preprotocol to postprotocol (83 vs. 63.6%; aRR: 0.62 [95% CI: 0.50–0.76]). There were no significant differences in abnormal umbilical cord blood gases or neonatal outcomes. Conclusion We did not find an increased risk of adverse outcomes associated with the widespread use of DCC.

Delayed cord clamping does not affect umbilical cord blood gas analysis

2019 ◽  
Vol 299 (3) ◽  
pp. 719-724 ◽  
Author(s):  
Jiachen Tang ◽  
Rachel Fullarton ◽  
Sheri-Lee Samson ◽  
Yu Chen
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Delayed Cord Clamping ◽  
Cord Clamping

The Impact of Introducing Universal Umbilical Cord Blood Gas Analysis and Lactate Measurement at Delivery

2014 ◽  
Vol 69 (6) ◽  
pp. 307-308
Author(s):  
Christopher R. H. White ◽  
Dorota A. Doherty ◽  
John P. Newnham ◽  
Craig E. Pennell
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Lactate Measurement ◽  
The Impact

scholarly journals An Immunological Perspective: What Happened to Pregnant Women After Recovering From COVID-19?

2021 ◽  
Vol 12 ◽  
Author(s):  
Sijia Zhao ◽  
Ting Xie ◽  
Li Shen ◽  
Hong Liu ◽  
Liling Wang ◽  
...  
Keyword(s):  
B Cells ◽  
Cord Blood ◽  
Pregnant Women ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Peripheral Blood ◽  
Immune Cell ◽  
Immune Cell Subsets ◽  
Significant Difference ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic has been raging around the world since January 2020. Pregnancy places the women in a unique immune scenario which may allow severe COVID‐19 disease. In this regard, the potential unknown effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on mothers and fetuses have attracted considerable attention. There is no clear consistent evidence of the changes in the immune status of pregnant women after recovery from COVID-19. In this study, we use multiparameter flow cytometry and Luminex assay to determine the immune cell subsets and cytokines, respectively, in the peripheral blood and umbilical cord blood from pregnant women recovering from COVID-19 about 3 months (n=5). Our results showed decreased percentages of Tc2, Tfh17, memory B cells, virus-specific NK cells, and increased percentages of naive B cells in the peripheral blood. Serum levels of IL-1ra and MCP-1 showed a decreased tendency in late recovery stage (LRS) patients. Meanwhile, there was no significant difference in immune cell subsets in the umbilical cord blood. The placentas from LRS patients showed increased CD68+ macrophages infiltration and mild hypoxic features. The inflammatory damage of the placenta may be related to the antiviral response. Since the receptors, ACE2 and TMPRSS2, utilized by SARS-CoV-2 are not co-expressed in the placenta, so it is extremely rare for SARS-CoV-2 to cause infection through this route and the impact on the fetus is negligible.

scholarly journals Cellular Subsets of Maternal Microchimerism in Umbilical Cord Blood

2018 ◽  
Vol 28 (5) ◽  
pp. 522-528
Author(s):  
Anna Maria Jonsson Kanold ◽  
Magnus Westgren ◽  
Cecilia Götherström
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Cesarean Sections ◽  
Hematopoietic Progenitor ◽  
Cord Clamping ◽  
Vaginal Deliveries ◽  
Umbilical Cord Clamping ◽  
Elective Cesarean ◽  
Total Dna

Maternal microchimerism may arise in the offspring during pregnancy, and may be favorable or unfavorable. Additionally, maternal cells present in umbilical cord blood used for stem cell transplantation may affect the outcome after transplantation. The aim of this study was to evaluate the cellular subset and frequency of maternal cells in umbilical cord blood following vaginal deliveries and elective Cesarean sections where the umbilical cord clamping time was measured. A total of 44 healthy women with normal pregnancies were included in the study. Of these, 24 delivered vaginally and 20 by elective Cesarean sections. In the fresh umbilical cord blood, cellular subsets of CD3+ (T-cells), CD19+ (B-cells), CD33+ (myeloid cells), CD34+ (hematopoietic progenitor cells) and CD56+ (natural killer cells) cells were isolated and DNA extracted. A single-nucleotide polymorphism unique to the mother was identified and maternal microchimerism in the different cellular fractions was detected using quantitative real-time polymerase chain reaction with a sensitivity of 0.01%. Overall, 5 out of the 44 (11%) umbilical cord blood samples contained maternal microchimerism. The positive fractions were total DNA (whole blood, n = 3), CD34+ ( n = 1), CD56+ ( n = 1) and CD34+/CD56+ ( n = 1). Overall, four of the five (80%) positive samples were from Cesarean sections and one was from a vaginal delivery. The conclusion from this study is that maternal microchimerism in umbilical cord blood is not a common phenomenon but includes both lymphoid and hematopoietic progenitor lineages.

The impact of nuchal cord on umbilical cord blood gas analysis and ischaemia-modified albumin levels in elective C-section

2018 ◽  
Vol 38 (8) ◽  
pp. 1099-1103 ◽  
Author(s):  
Aslı Yarcı Gursoy ◽  
Burcin Ozgu ◽  
Yasemin Tasci ◽  
Tuba Candar ◽  
Salim Erkaya ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Nuchal Cord ◽  
The Impact

scholarly journals CD34+ stem cells from umbilical cord blood

2011 ◽  
Vol 1 (3) ◽  
pp. 79 ◽  
Author(s):  
Carlo Pafumi ◽  
Vito Leanza ◽  
Antonio Carbonaro ◽  
Gianluca Leanza ◽  
Alessandra Iemmola ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Survival Rates ◽  
Blood Collection ◽  
Colony Forming Unit ◽  
Cord Clamping ◽  
Umbilical Cord Clamping

We describe the relation between umbilical cord clamping time and two different enrichment system of CD34+ stem cells from umbilical cord blood with the proliferative ability and bone marrow reconstitution of the stem cells obtained. After an obstetrician performed the cord blood collection, the purification of stem cells was performed either with a combination of monoclonal antibodies (negative selections) using the Stem Sep method, or with a positive cells selection based on their surface CD34 antigens using the Mini Macs system. An excellent recovery of haematopoietic progenitors [Burst Forming Unit Erythroids (BFUE); Colony Forming Unit Granulocytes and Macrophages (CFU-GM); and Colony Forming Unit Granulocytes, Erythroids, Monocytes and Macrophages (CFU-GME)], inversely related to the increase in clamping time, was performed with the Mini Macs system (54% of colonies, with 90% purity). With Stem Sep method, haematopoietic progenitor’s recovery was 35% (with 80% purity). By applying early clamping of umbilical cord blood we obtained a greater number of CD34+ cells and their clonogenic activity was increased with enrichment. This is a useful technique considering that the number of CD34+ stem cells usually contained from a unit of placental blood is enough for the transplant to a child, but not for an adult. Thus, using these methods, we can get a larger number of CD34+ stem cells which reduces the risk of Graft versus Host Disease also in adult patients, producing survival rates similar to those obtained with transplantation of bone marrow from unrelated donors.

scholarly journals The Impact of Umbilical Cord Clamping Time on the Infant Anemia: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Sevil Güner ◽  
Birsen Karaca Saydam
Keyword(s):  
Randomized Controlled Trial ◽  
Umbilical Cord ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Cord Clamping ◽  
Significant Difference ◽  
Umbilical Cord Clamping ◽  
The Impact

Background: Anemia during infancy causes irreversible physical, cognitive, motor, and behavioral development disorders. This study aimed to determine the effect of delaying umbilical cord clamping time on certain parameters regarding anemia during the infancy. Methods: This randomized controlled trial was conducted at a university hospital in west of Turkey (Dec 2017- Dec 2018). Overall, 110 participants were evaluated for the research, 65 participants were randomized after excluding those who did not meet the inclusion criteria (intervention=32, control=33). Randomly assigned to delayed clamping (1 min after delivery) or early clamping (in 15 sec after delivery), and followed up until 4 months postpartum. 48th-hour hematocrit, bilirubin values, need for phototherapy and hematocrit, hemoglobin values, diagnosis of anemia at the postnatal fourth month were compared between two groups. The data showing normal distribution were assessed using the parametric tests. The level of statistical significance was determined as P<0.05. Results: The 48th-hour hematocrit and bilirubin levels of the intervention group were significantly higher than the control (P<0.01 and P<0.05, respectively). No significant difference regarding the need for phototherapy due to postnatal hyperbilirubinemia was observed between the two groups (P>0.05). Means of the intervention group hematocrit and hemoglobin levels measured during anemia screening performed at the fourth month were found to be higher than those of the infants in the control group (P<0.05 and P<0.05, respectively). Conclusion: Delaying umbilical cord clamping had a positive impact on the haematological parameters of infants. Clamping the cord at least one minute in birth can be performed to prevent the iron deficit anemia that could be seen during the first years of infants’ lives.

Sign in / Sign up

Export Citation Format

Share Document