scholarly journals A study of effect of delayed and early umbilical cord clamping on neonatal haemoglobin status

2021 ◽  
Vol 10 (6) ◽  
pp. 2268
Author(s):  
Jyoti Jaiswal ◽  
Krishna Kumar Dehariya ◽  
Devina Nagraj
Keyword(s):  
Haemoglobin Level ◽  
Umbilical Cord ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Wide Range ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
Umbilical Cord Clamping ◽  
Neonatal Blood ◽  
Definition Of

Background: Delayed cord clamping has been supported by physician because it allows for physiological transfer of blood from placenta to the infant and thus permits placenta to newborn transfusion and results in an increased neonatal blood volume at birth. At present there is no standard definition of delayed cord clamping. Clamping time varies significantly between studies and a wide range of parameters were used for clamping of cord.Methods: This was an observational study conducted in a public hospital among 200 uncomplicated full-term pregnancies where 100 each were present in early cord clamping (ECC) and delayed cord clamping (DCC) groups respectively and neonatal haematological parameters studied according to different cord clamping times.Results: There was a significant increase of mean haemoglobin level from 14.8 to 16.0 g/dl from 15 secs to 60 secs and gradual increase of mean haemoglobin level from 16.2 to 16.8 g/dl from 60 secs to 180 secs. There was a highly significant difference between ECC and DCC groups regarding mean haemoglobin level and MCH values. MCV and MCH values were also significantly different in both the groups.Conclusions: We concluded in this study that delayed cord clamping, resulted in improved haemoglobin and other haematocrit levels specially when cord was clamped after first 60 secs. Delayed clamping also reduced the prevalence of neonatal anaemia at 2 days of age. In terms of maternal outcomes, delayed umbilical cord clamping did not increase the risk of postpartum haemorrhage or the need for blood transfusion.

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.

scholarly journals Assessment of effectiveness of delayed cord clamping and umbilical cord milking in early term and preterm infants

2018 ◽  
Vol 5 (6) ◽  
pp. 2071
Author(s):  
Mahendra K. Jain ◽  
Nidhi Bhedru ◽  
Anubhuti Jain
Keyword(s):  
Umbilical Cord ◽  
Randomized Study ◽  
Delayed Cord Clamping ◽  
Term Infants ◽  
Early Term ◽  
Cord Clamping ◽  
Significant Difference ◽  
Insignificant Difference ◽  
Nicu Admission ◽  
Umbilical Cord Milking

Background: Early cord clamping and cutting of the umbilical cord is widely practiced as part of the management of labor; it could deprive the neonate of about a quarter of its blood volume and iron. This thesis is aimed at comparing effects of delayed cord clamping versus umbilical cord milking at birth in preterm and early term infants.Methods: This single centered randomized study was conducted in Department of Pediatrics and data collection was done on the basis of the preterm and early term infants delivered by vaginal or cesarean delivery in Department of Gynecology, Geetanjali Medical College and Hospital, Udaipur during period of January 2016 to January 2017. Total of 120 infants were included in the study.Results: Statistically it has been analyzed that in both pre-term and early term infants who underwent DDC and UCM, there was insignificant difference in level of hemoglobin (Hb), haematocrit (HCT), blood sugar, bilirubin level (TSB) and temperature of body. On the other hand, significant difference was observed in weight and cord pH of neonates of both groups. There is also insignificant difference in terms of NICU admission for RDS, sepsis, phototherapy, need of oxygen, saline boluses, PRBC transfusion, polycythemia.Conclusions: Thus, overall it was observed that there is insignificant difference in delayed cord clamping and umbilical cord milking group. Thus, both are found to be equally effective in improving hematologic parameters. 

scholarly journals Current umbilical cord clamping practices and attitudes of obstetricians and midwives toward delayed cord clamping in Saudi Arabia

2017 ◽  
Vol 37 (3) ◽  
pp. 216-224 ◽  
Author(s):  
Nadia O. Ibrahim ◽  
Hatouf H. Sukkarieh ◽  
Rami T. Bustami ◽  
Elaf A. Alshammari ◽  
Lama Y. Alasmari ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Umbilical Cord ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Umbilical 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 How to Provide Motherside Neonatal Resuscitation with Intact Placental Circulation?

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 291
Author(s):  
David Hutchon ◽  
Simone Pratesi ◽  
Anup Katheria
Keyword(s):  
Umbilical Cord ◽  
Neonatal Resuscitation ◽  
Delayed Cord Clamping ◽  
Apgar Scores ◽  
Oxygen Levels ◽  
Is Implementation ◽  
Cord Clamping ◽  
Early Cord Clamping ◽  
Physiological Outcomes

Immediate clamping and cutting of the umbilical cord have been associated with death and/or neurodisability [1–5]. Given the harm from immediate cord clamping it would seem logical that all infants should receive delayed cord clamping, but evidence for delayed cord clamping when resuscitation is required is limited. One approach would be to perform resuscitation while the cord is still intact. Several studies have demonstrated improvements in physiological outcomes, such as higher Apgar scores or oxygen levels in the first few minutes of birth with resuscitation with an intact cord compared to early cord clamping [6–11]. Another challenge, however, is implementation of this practice. While some groups have reported this practice to be relatively straightforward [11–16], others have struggled with its [...]

scholarly journals Delayed Umbilical Cord Clamping is Not Associated with Acute Kidney Injury in Very Low Birth Weight Neonates

2019 ◽  
Vol 37 (02) ◽  
pp. 210-215
Author(s):  
Matthew W. Harer ◽  
Ryan M. McAdams ◽  
Mark Conaway ◽  
Brooke D. Vergales ◽  
Dylan M. Hyatt ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Umbilical Cord ◽  
Very Low Birth Weight ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Umbilical Cord Clamping

Abstract Objective This study aimed to determine if delayed cord clamping (DCC) is associated with a reduction in neonatal acute kidney injury (AKI). Study Design A retrospective single-center cohort study of 278 very low birth weight (VLBW) neonates was performed to compare the incidence of AKI in the following groups: immediate cord clamping (ICC), DCC, and umbilical cord milking. AKI was diagnosed by the modified neonatal Kidney Diseases and Improving Global Outcomes (KDIGO) definition. Results The incidence of AKI in the first week was 20.1% with no difference between groups (p = 0.78). After adjustment for potential confounders, the odds of developing AKI, following DCC, compared with ICC was 0.93 (confidence interval [CI]: 0.46–1.86) with no reduction in the stage of AKI between groups. Conclusion In this study, DCC was not associated with a reduced rate of AKI in VLBW neonates. However, the data suggest that DCC is also not harmful to the kidneys, further supporting the safety of DCC in VLBW neonates.

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.

Epidemiological Investigation on the Current Practice of Umbilical Cord Clamping in China

2020 ◽  
Author(s):  
Juanjuan Zhu ◽  
Yujie Xie ◽  
Bei Wang ◽  
Yiwen Wang ◽  
Henry Akinbi ◽  
...  
Keyword(s):  
Health Care ◽  
Umbilical Cord ◽  
Health Care Providers ◽  
Daily Practice ◽  
Systemic Circulation ◽  
Medical Professional ◽  
Care Providers ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Umbilical Cord Clamping

Objective Despite known benefits, the timing of and method used for umbilical cord clamping (UCC) in neonates remain controversial in China, as well as internationally. The objective of this study was to assess knowledge, attitudes, and practice of UCC amongst health care providers in China, as recommended by medical professional organizations. Study Design A web-based questionnaire on cord clamping practices was administered to midwives, obstetricians, and neonatologists in 126 hospitals from 16 provinces. The provinces were selected from seven different regions of China. Results A total of 5,005 (60.5% of eligible respondents) health care providers returned completed questionnaires. The awareness rates for immediate cord clamping (ICC) and delayed cord clamping (DCC) were over 85%, but the implementation rate for DCC was relatively low (ICC 58.3% vs. DCC 41.6%). Most neonates were placed below the introitus (92.8%) during cord clamping and this correlated with the route of delivery. The choice of UCC was impelled by different factors. Benefits for neonates influenced the choice of ICC (50%) and promoting a larger blood volume to stabilize systemic circulation influenced the choice of DCC (92.3%). Majority (91.5%) of respondents acquiesced that it was necessary to develop national clinical guidelines for UCC. Conclusion The majority of obstetricians, neonatologists, and midwives who participated in this study had a positive perception of DCC. However, this did not translate to daily practice. The practice of UCC is variable and there are no standard guidelines. Key Points

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