Delayed Cord Clamping: A Collaborative Practice to Improve Outcomes

2013 ◽  
Vol 32 (5) ◽  
pp. 369-373 ◽  
Author(s):  
Patricia Scheans
Keyword(s):  
Umbilical Cord ◽  
Collaborative Practice ◽  
Optimal Timing ◽  
Long Term Outcomes ◽  
Delayed Cord Clamping ◽  
Team Collaboration ◽  
Neonatal Nurses ◽  
Cord Clamping ◽  
Short And Long Term

Delayed cord clamping is a collaboration between the obstetric team and the neonatal team. Although the optimal timing for clamping the umbilical cord after birth continues to be subject to study, delaying clamping for at least 30–60 seconds, with the newborn held at or below the level of the uterus/placenta supports normal physiology and has proven benefits. Practical issues such as thermoregulation and equipment can be overcome with team collaboration and prebriefing planning. Neonatal nurses who attend deliveries are perfectly poised to influence this practice and improve short- and long-term outcomes for their patients.

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.

Placement of Endosseous Implants in Grafted Alveolar Clefts

1997 ◽  
Vol 34 (6) ◽  
pp. 520-525 ◽  
Author(s):  
Gerard Kearns ◽  
David H. Perrott ◽  
Arun Sharma ◽  
Leonard B. Kaban ◽  
Karin Vargervik
Keyword(s):  
Bone Volume ◽  
Optimal Timing ◽  
Long Term Outcomes ◽  
Incisor Tooth ◽  
Endosseous Implants ◽  
Alveolar Cleft ◽  
Oronasal Fistula ◽  
Implant Placement ◽  
Short And Long Term

Objective: The purpose of this study was to determine the optimal timing for placement and to evaluate short- and long-term outcomes of endosseous implants in bone-grafted alveolar clefts. Design: Fourteen patients who underwent alveolar cleft bone grafting (ACBG) and closure of an oronasal fistula followed by restoration of the missing lateral incisor tooth using endosseous implants (EI) were studied. The oronasal fistulae were closed using local flaps, and the alveolus was grafted with fresh autogenous iliac marrow. Endosseous implants were placed a minimum of 4 months following ACBG. The average age at ACBG was 20.35 years (range, 12–65 yr), and at implant placement 22.2 years (range, 15–66 yr). It was necessary to regraft the alveolar cleft region in six patients to provide adequate bone volume for implant placement. Those who required alveolar regrafting had an increased mean interval between the initial ACBG and planned implant placement compared to the patients with adequate bone available for implant placement 26.4 months (range, 4–46 mo) versus 15.75 months (range, 4–36 mo). Results: Twenty-nine implants were placed in 14 patients, 9 outside of the cleft region and 20 in grafted alveolar clefts. Eighteen of 20 (90%) implants in the bone-grafted alveolar clefts have been successfully restored. The mean followup after implant placement was 39.1 months (range, 1–54 mo), and after restoration 28.5 months (range, 1–47 mo). Conclusions: Endosseous implants can be placed in bone-grafted alveolar clefts. Consideration should be given to the adequacy of graft volume and ridge morphology at the time of ACBG. The interval between ACBG and implant placement is important. The greater the interval beyond 4 months, the more likely there will be inadequate bone volume to accept an implant.

scholarly journals Immediate effects of clamping of the umbilical cord on the newborns

2019 ◽  
Vol 6 (3) ◽  
pp. 1251
Author(s):  
Muhammad Hassan ◽  
Adarsh E. ◽  
Sahana Manjunath ◽  
Shivtej N. ◽  
Archana D. V. ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
World Health ◽  
Optimal Time ◽  
Optimal Timing ◽  
Delayed Cord Clamping ◽  
Medical College ◽  
Cord Clamping ◽  
Third Stage ◽  
Umbilical Cord Clamping ◽  
Health Organization

Background: The optimal timing of cord clamping has been a controversial issue for decades. Most practitioners in developing countries clamp and cut the cord immediately after birth and this takes place during the third stage of labour. World Health Organization advises late cord clamping, however there is a debate on the optimal time for cord clamping. Delayed umbilical cord clamping appears to be beneficial for term and preterm infants.Methods: This observational study was undertaken at Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India from June 2018 to January 2019.Results: Total 100 neonates were studied of which 48 were females (48%) and 52 were males (52%). 76 babies (76%) were 3 day old in this study and 24 babies were (24%) 4 day old during the study period. 92 babies (92%) didn’t receive phototherapy in this study and 8 babies (8%) required phototherapy during the study period. No babies were polycythemic during this study period. Mean TB was 11.832 whereas mean DB was 0.5. Mean HCT was 56.332 and mean HB was 18.3002.Conclusions: Present study concluded that there are various advantages if authors practiced delayed cord clamping including higher levels of haemoglobin and haematocrit levels.

Obstetrical and neonatal factors associated with optimal public banking of umbilical cord blood in the context of delayed cord clamping

2019 ◽  
Vol 42 (3) ◽  
pp. E56-E63 ◽  
Author(s):  
Anna Munro ◽  
Daniel J. Corsi ◽  
Lisa Martin ◽  
Michael Halpenny ◽  
Nicholas Dibdin ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Delayed Cord Clamping ◽  
Factors Associated ◽  
Cell Counts ◽  
Cord Clamping ◽  
Newborn Weight ◽  
Cord Blood Banks

Purpose: To assess the association of specific newborn and maternal factors with indicators of increased blood-forming capacity in umbilical cord blood to inform strategic collection strategies that could augment the quality of units in public cord blood banks. Methods: Data regarding 268 consecutive cord blood units (CBUs) banked by Canadian Blood Services were analyzed. Multivariate analysis was performed to identify factors associated with markers of hematopoietic potency and likelihood of utilization. Results: Delayed clamping of the cord beyond 60 s was associated with reduced volume collected. Any delay in clamping of the cord was associated with reduced total nucleated cell counts. Newborn weight >4,000 g was also associated with greater blood volume in the collection but not with other measures of hematopoietic potency. Cord blood acidosis at birth (pH

scholarly journals Sustained Inflation Reduces Pulmonary Blood Flow during Resuscitation with an Intact Cord

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 353
Author(s):  
Jayasree Nair ◽  
Lauren Davidson ◽  
Sylvia Gugino ◽  
Carmon Koenigsknecht ◽  
Justin Helman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Perinatal Asphyxia ◽  
Arterial Blood Flow ◽  
Positive Pressure ◽  
Optimal Timing ◽  
Delayed Cord Clamping ◽  
Arterial Blood ◽  
Cord Clamping ◽  
Sustained Inflation ◽  
Near Term

The optimal timing of cord clamping in asphyxia is not known. Our aims were to determine the effect of ventilation (sustained inflation–SI vs. positive pressure ventilation–V) with early (ECC) or delayed cord clamping (DCC) in asphyxiated near-term lambs. We hypothesized that SI with DCC improves gas exchange and hemodynamics in near-term lambs with asphyxial bradycardia. A total of 28 lambs were asphyxiated to a mean blood pressure of 22 mmHg. Lambs were randomized based on the timing of cord clamping (ECC—immediate, DCC—60 s) and mode of initial ventilation into five groups: ECC + V, ECC + SI, DCC, DCC + V and DCC + SI. The magnitude of placental transfusion was assessed using biotinylated RBC. Though an asphyxial bradycardia model, 2–3 lambs in each group were arrested. There was no difference in primary outcomes, the time to reach baseline carotid blood flow (CBF), HR ≥ 100 bpm or MBP ≥ 40 mmHg. SI reduced pulmonary (PBF) and umbilical venous (UV) blood flow without affecting CBF or umbilical arterial blood flow. A significant reduction in PBF with SI persisted for a few minutes after birth. In our model of perinatal asphyxia, an initial SI breath increased airway pressure, and reduced PBF and UV return with an intact cord. Further clinical studies evaluating the timing of cord clamping and ventilation strategy in asphyxiated infants are warranted.

Sign in / Sign up

Export Citation Format

Share Document