In the third stage of labor, is delayed cord clamping beneficial compared with early cord clamping for term neonates?

2016 ◽  
Vol 19 (2) ◽  
pp. 6
Author(s):  
Michael Chase Ledbetter ◽  
Mitchell Duininck
Keyword(s):  
Delayed Cord Clamping ◽  
Term Neonates ◽  
The Third ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Early Cord Clamping

scholarly journals Delayed Cord Clamping in Term Neonates: Attitudes and Practices of Midwives in Irish Hospitals

2018 ◽  
Vol 8 (1) ◽  
pp. 4-17 ◽  
Author(s):  
Joan Devin ◽  
Patricia Larkin
Keyword(s):  
Umbilical Cord ◽  
Active Management ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
The Third ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Maternity Hospitals ◽  
Third Stage ◽  
Early Cord Clamping

Background:At the time of birth, the baby is attached to its mother’s placenta via the umbilical cord. A delay in cord clamping is physiologically beneficial to the neonate as they receive an increase in blood volume (30%–40%), increased iron stores (20–30mg/kg), and an easier transition to extrauterine life. Active management of the third stage of labor, in order to prevent maternal postpartum hemorrhage, may contribute to early cord clamping practices in Ireland. Objective:To describe the current practices and attitudes of midwives in Irish hospitals toward delayed cord clamping in term neonates. Methods:A cross-sectional descriptive survey was distributed to three maternity hospitals and two Irish online midwifery groups. Results:One hundred and fifty-three valid responses were received. One hundred and eleven midwives (72.4%) defined delayed cord clamping as “clamping after the cord ceases to pulsate.” One hundred and forty (91.5%) respondents practiced delayed cord clamping. Moreover, 62.7 % (98/153) of participants routinely clamp the umbilical cord >1 minute when practicing active management of the third stage, with 49.1% (48/98) of those waiting until cord pulsations have ceased. Awareness of research, practice guidelines advising delayed cord clamping, and experience of practicing physiological third stage are associated with increased delayed cord clamping practices. Early cord clamping is influenced by a deteriorating neonatal or maternal condition and the cultural context within clinical sites. Delayed cord clamping times during active management of the third stage differ significantly between clinical sites and maternity care pathways.Conclusion:A variety of midwifery practices were identified with differing attitudes toward cord clamping practices. Diverse influences included the practice environment, awareness of research, and availability of adjunct resuscitation supports. Recommendations for future practice include a synchronized approach to delayed cord clamping in the third stage of labor, including the provision of a national guideline.

Comparison of Policies for the Management of Care for Women and Newborns During the Third Stage of Labor Among Japanese Hospitals, Clinics, and Midwifery Birth Centers

2015 ◽  
Vol 5 (4) ◽  
pp. 200-209 ◽  
Author(s):  
Yaeko Kataoka ◽  
Kaori Nakayama ◽  
Yukari Yaju ◽  
Hiromi Eto ◽  
Shigeko Horiuchi
Keyword(s):  
Postal Questionnaire ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Third ◽  
Skin Contact ◽  
Birth Centers ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Care Policies

OBJECTIVE: To determine the care policies for both mothers and newborns implemented during and after the third stage of labor and to compare the rate of adoption of these care policies among hospitals, clinics, and midwifery birth centers in Japan.METHOD: A cross-sectional survey of the care policies affecting mothers and newborns during and after the third stage of labor was conducted from October 2010 to July 2011. A postal questionnaire with follow-up was sent to all 684 maternity institutions in Tokyo metropolitan areas.RESULTS: The overall response rate was 255 (37%). Most hospitals and clinics had a policy of early cord clamping; however, nearly 70% of the midwifery birth centers adopted the policy of waiting until the cord stopped pulsating. The policy of administering prophylactic uterotonics was adopted by 50% of the hospitals and 63% of the clinics, although midwifery birth centers did not adopt this policy. All midwifery birth centers, 50% of the hospitals, and 50% of the clinics routinely adopted the policy of early skin-to-skin contact.CONCLUSION: Adoption of various care policies differed considerably among the hospitals, clinics, and midwifery birth centers. In addition, there were several gaps between evidence-based care and care policies.

scholarly journals Effect of early and delayed cord clamping on hemoglobin and hematocrit among full term neonates.

2021 ◽  
Vol 28 (08) ◽  
pp. 1114-1119
Author(s):  
Saqib Aslam ◽  
◽  
Sadaf Minhas ◽  
Muhammad Azhar Farooq ◽  
Beenish Bashir Mughal ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Full Term ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Cord Clamping ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
The Mean

Objective: To compare the mean hemoglobin levels and frequency of polycythemia in full term neonates after early and delayed cord clamping. Study Design: Randomized Controlled Trial. Setting: KRL General Hospital Islamabad (Labor Room/ Neonatology). Periods: December 2017 to June 2018. Material & Methods: 190 full term neonates were selected and divided into 2 equal groups randomly: Early cord clamping group after delivery and late cord clamping group. Two hours after clamping the venous blood samples were taken for the hemoglobin and hematocrit levels. Mean and standard deviation were calculated for gestational age, birth weight, hemoglobin and hematocrit. Frequency and proportions were calculated for gender and polycythemia. Results: Mean gestational age of the mothers was 39.27 ± 1.50 weeks. Of 190 neonates, 91 (47.9%) were males, 99 (52.1%) were females. Mean birth weight was 3.64 ± 0.72 kg while mean Hb and HCT levels were 16.07 ± 2.30 g/dl and 63.26 ± 5.32% respectively. Keeping cut off value of 13.5 g/dl of Hb to label anemia or no, 35 (18.4%) neonates were anemic in this study. The polycythemia (HCT >65%) was present in 72 (37.9%) of neonates. There was no difference between groups in terms of gender, anemia, gestational age and birth weight (p values 0.663, 0.852, 0.700 and 0.491 respectively). The distribution of polycythemia was different among groups (p value 0.007). The mean hemoglobin level in group A was 15.52 ± 1.90 g/dl while in group B it was 16.62 ± 2.53 g/dl (p value 0.001). Mean Hb levels were statistically not different among some of the groups (gestational age <40 weeks, birth weight <4 kg) while HCT levels are significantly different among male group and category of birth weight >4 kg. Rest of the stratification groups showed significant difference. Conclusion: The delayed cord clamping in neonates results in increased mean hemoglobin and hematocrit levels with increased frequency of polycythemia as compared to early cord clamping.

Early versus delayed cord clamping in term neonates.

2021 ◽  
Vol 28 (05) ◽  
pp. 656-660
Author(s):  
Samina Mumtaz ◽  
Shagufta Tabassum ◽  
Saima Afzal
Keyword(s):  
Gestational Age ◽  
Controlled Trial ◽  
Hemoglobin Level ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Cord Clamping ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
Group A ◽  
Group B

Objective: To compare mean hemoglobin levels of neonates after early and late cord clamping. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics & Gynaecology at Nishtar Hospital Multan. Period: June 2019 to December 2019. Material & Methods: A total of 60 women booked and unbooked were included in study. Selected patients randomized into group A and B, each group comprising of 30 patients depending upon the envelope with assigned treatment (either early or delayed cord clamping) picked up by the patient. Results: In present study, two groups were made. Group A consisted of 30 neonates in whom early cord clamping was done while in group B delayed clamping was done in 30 neonates. Mean age of mothers was 28.4±0.4 vs. 28.6±0.5 years in group A and B respectively. There were 25 mothers (83.3%) in group A and 21 mothers (70%) in group B between 25–30 years. There were 5 mothers (16.7%) in group A and 8 mothers (26.7%) in group B between 31–35 years of age. While none of the mother in group A and 1 mother (3.3%) in group B was between 36–40 years of age. Mean parity of the mothers was 1.1±0.2 vs. 1.4±0.2 in group A and B respectively. Eight mothers (85.4%) in group A and 7 mothers (82.5%) in group B were primipara. While 22 mothers (14.6%) in group A and 23 mothers in group B (17.5%) were para 1–3. Gestational age was 37–38 weeks in 13(43.3%) vs. 19(63.3%) women in group A and B respectively. While there were 17(56.7%) vs. 11(36.7%) women in group A and B respectively of the gestational age 39–40 weeks. Pre-delivery maternal mean hemoglobin levels was 11.9±0.1 gm/dl vs. 12.3±0.1 gm/dl in group A and B respectively. Pre-delivery maternal hemoglobin levels were 10–10.9 g/dl in 2 mothers (6.7%) vs. 1 mother (3.3%) in group A and B respectively. Neonatal mean hemoglobin levels were 16.8±0.2 g/dl vs. 17.7±0.1 g/dl in group A and B respectively. Out of the 31 booked mothers, neonatal mean hemoglobin level was 16.8±0.2 g/dl vs. 17.9±0.1 g/dl in group A and B respectively. While out of the 29 unbooked mothers, neonatal mean hemoglobin level was 16.7±0.2 g/dl vs. 17.5±0.1 g/dl in group A and B respectively. When compared the neonatal mean hemoglobin levels, there was significant difference between mean hemoglobin levels of neonates between the two groups (p=0.000). Conclusion: Delayed cord clamping in term neonates for a minimum of 2 minutes at birth is beneficial to the newborn in terms of improved hemoglobin levels. There is no significant difference seen in pre-delivery maternal hemoglobin levels and neonatal hemoglobin either in delayed cord clamping group or in early cord clamping group.

scholarly journals Effects of delayed cord clamping on neonatal jaundice, phototherapy and early hematological status in term cesarean section

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Hailing Shao ◽  
Shichu Gao ◽  
Qiujing Lu ◽  
Xiaomin Zhao ◽  
Ying Hua ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Neonatal Jaundice ◽  
Maternal Blood ◽  
Optimal Timing ◽  
Short Term ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Transcutaneous Bilirubin ◽  
Cord Clamping ◽  
Early Cord Clamping

Abstract Background Delayed cord clamping in full-term neonates is widely recommended, while in practice, it is rarely implemented in cesarean section due to the fear of neonatal jaundice and excessive maternal blood loss. The optimal timing of cord clamping remains uncertain. This study was to fully evaluate the effects of delayed cord clamping on short-term hematological status and jaundice in term neonates delivered by cesarean section. Methods This retrospective study enrolled 796 women, who were allocated into the early cord clamping group (n = 377) and the delayed cord clamping group (n = 419). The latter group was further divided into two subgroups (30–60 s, 61–120 s). The outcomes were neonatal transcutaneous bilirubin levels on 0 to 5 days of life and the rate of phototherapy. For neonates who had blood tests on the first three days of life, their hemoglobin and hematocrit were compared among groups. Results Compared with the early cord clamping group, delayed cord clamping merely increased the transcutaneous bilirubin level of neonates on the day of birth rather than that on the following five days. The heel peripheral blood sample size of 1–3 days in the early cord clamping group was 61, 25 and 33, and in the delayed cord clamping group was 53, 46 and 32, respectively. Delayed cord clamping at 30–60 s resulted in the higher neonatal hemoglobin level on day 3 and an increased rate of neonatal polycythemia, without a higher rate of phototherapy. Delayed cord clamping beyond 60 s did not further improve hematological status in term neonates born by cesarean section. Conclusion In cesarean section, delayed cord clamping for 30–60 s improved the early hematological status of term neonates without the enhanced requirement of phototherapy for neonatal jaundice.

scholarly journals Management of the Third Stage of Labor: How Delayed Umbilical Cord Clamping Can Affect Neonatal Outcome

2017 ◽  
Vol 34 (14) ◽  
pp. 1375-1381 ◽  
Author(s):  
Mitchell Kresch
Keyword(s):  
Umbilical Cord ◽  
Neonatal Resuscitation ◽  
Delayed Cord Clamping ◽  
Ample Evidence ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Umbilical Cord Clamping ◽  
Short And Long Term

AbstractThis review presents the effects of delayed umbilical cord clamping on neonatal transitional physiology. The effects of delayed cord clamping on short- and long-term neonatal outcomes are then discussed. There is ample evidence over the last 50 years that delayed cord clamping in preterm infants is beneficial for both short-term and long-term outcomes. Providing ventilation in the initial steps of neonatal resuscitation prior to clamping of the umbilical cord has a physiologic basis and results in better outcomes for newborns. The challenge now is to design equipment and strategies that can allow initial resuscitation very close to the mother while the umbilical cord is still attached to the placenta.

scholarly journals PRIMERJAVA PREDNOSTI IN SLABOSTI TAKOJŠNJE TER ODLOŽENE PREKINITVE POPKOVNICE PRI NOVOROJENČKU

2015 ◽  
Vol 84 (7-8) ◽  
Author(s):  
Tamara Serdinšek ◽  
Andraž Dovnik ◽  
Iztok Takač
Keyword(s):  
Respiratory Distress ◽  
Active Management ◽  
Preterm Neonates ◽  
Delayed Cord Clamping ◽  
Birth Canal ◽  
The Third ◽  
Cord Clamping ◽  
Third Stage ◽  
Umbilical Cord Clamping ◽  
The Usa

Background: Umbilical cord clamping in the third stage of labour is still controversial. Early cord clamping is defined as clamping at 10, 15, 30 or 60 seconds after delivery and delayed as clamping after 60 seconds or at 2-5 minutes after delivery, when the cord stops pulsating or when the placenta is visible within the birth canal. Early clamping is one of the three components of active management of the third stage of labour, which has been used widely in modern obstetrics during the last century. However, in some northern European countries, various parts of the USA and Canada and in developing countries physiological management is preferred.Conclusions: After publication of several trials describing advantages of delayed clamping, this has recently been progressively replacing early clamping. The most important advantages of delayed cord clamping are higher haemoglobin and ferritin levels, higher iron stores, lower incidence of iron deficiency anaemia, better cardiopulmonary adaptation, lower rate of respiratory distress syndrome, and longer duration of early breastfeeding in term neonates, while there is no increase in the incidence of postpartum haemorrhage. Delayed clamping seems to bring some advantages for preterm neonates as well. However, caution is still advised because of the potential adverse effects, especially polycythaemia with hyperviscosity, hyperbilirubinaemia and respiratory distress.

scholarly journals Placental Blood Drainage Shortens Duration of the Third Stage of Labor in Women Slowly Administered 20 IU Oxytocin

2016 ◽  
pp. 1
Author(s):  
Metin Kaba ◽  
Yaprak Engin Üstün ◽  
Elif Gül Yapar Eyi ◽  
Hakan Timur ◽  
Bekir Serdar Ünlü ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Control Group ◽  
Stage Duration ◽  
The Third ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Vaginal Deliveries ◽  
Third Stage

<p><strong>Objective:</strong> Prolongation of the third stage of labor may cause serious postpartum complications. Thus, timely expulsion of the placenta is essential for preventing complications of the third stage of labor. We conducted a prospective cohort study to determine the effect of placental cord drainage on the duration of the TSL in women administered intravenous oxytocin during this stage.<br /><strong>Study Design:</strong> This was a prospective cohort study in which 112 low risk pregnant women were allocated to the study. There were 53 women in the placental cord drainage group, and 59 women in the cord clamping group without drainage. Immediately after fetal delivery, intravenous infusion of 20 IU oxytocin in 500 mL Ringers’ Lactate was started and infused within 2 hours in women in both groups. Outcome measures were the third stage duration and hemoglobin differences between admission and the postpartum sixth hour. <br /><strong>Results:</strong> There were no significant differences between the two groups with regard to duration of stages 1 and 2 of labor, hemoglobin level on admission, and at the postpartum sixth hour, and hemoglobin differences between admission and the postpartum sixth hour. The median third stage duration in the study group was 3.40 (range: 0.35-16.20) minutes, and 5.10 (range: 2.30-11.00) minutes in the control group. This difference between the groups was statistically significant (p&lt;0.01). <br /><strong>Conclusion:</strong> Placental cord drainage reduces the third stage duration following vaginal deliveries in patients receiving intravenous oxytocin. Placental cord drainage is simple, does not require additional cost, and is applicable for every delivery.</p>

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