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 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 Antibiotic prophylaxis before skin incision versus after cord clamping in the prevention of maternal and neonatal infectious morbidity after cesarean section

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W H Eltantawy ◽  
K M Labib ◽  
A M Farag
Keyword(s):  
Cesarean Section ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Gestational Age ◽  
Skin Incision ◽  
Infectious Morbidity ◽  
Cord Clamping ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background the purpose of antibiotic prophylaxis in surgical procedures is not to sterilize tissues but to reduce colonisation pressure of microorganisms introduced at the time of the operation to a level that can be overcome by the patient’s immune system. Aim of the study to compare the effects of antibiotic prophylaxis administered in cesarean section preoperatively versus after neonatal cord clamp on postoperative infectious complications for both the mother and the neonate. Patients and Methods This comparative study was carried out between August 2017 and February 2018, at Ain Shams maternity hospital and Al-Galaa teaching hospital, a prospective randomized control comparativestudy of 874 pregnant ladies undergoing cesarean section after obtaining the approval of the local ethical committee and a fully-informed written consent. Results Of 874 pregnant ladies undergoing cesarean section, mean gestational age in group A (38.71±1.09); while in group B mean gestational age (38.86±1.06). In group A, wound infection 8 cases (1.6%), endometritis 25 cases (5.7%), UTI 18 case (4.1%). In group B, wound infection 16 cases (3.7%), endometritis 35 cases (8%), UTI 28 case (6.4%). No cases suffered from early or long term neonatal complications. Conclusion there is no significant difference between timing of antibiotic either before skin incision or after cord clamping, however there are risk factors that increase the maternal, fetal infectious morbidity as high BMI, low gestational age, previous section, general anaesthesia.

scholarly journals Timing of Cord Clamping and it's Effect on Haematocrit and Clinical Outcome of Neonate

1970 ◽  
Vol 33 (1) ◽  
pp. 16-21
Author(s):  
Ujjal Mitra ◽  
Md Shahidullah ◽  
Abdul Mannan ◽  
Zakia Nahar ◽  
Sanjoy Kumar Dey ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Controlled Trial ◽  
Study Groups ◽  
Delayed Cord Clamping ◽  
Usual Practice ◽  
Cord Clamping ◽  
Group I ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
Group Ii

Background: It is the usual practice to clamp umbilical cord immediately after birth.There is no sound evidence to support this approach, which might deprive the newbornof some benefits, such an increase in iron storage.Objectives: The study was done to determine the effect of timing of cord clamping onneonatal venous haemoglobin and haematocrit values and clinical outcome withinneonatal period.Methodology: This was a randomized, controlled trial performed in Obstetrical Unitwith support of Neonatal Unit of Paediatrics and Department of Clinical Pathology ofBSMMU on neonates born at term without complication to mothers with uneventfulpregnancies. After obtaining written parental consent newborns were randomly assignedto cord clamping within first 15 seconds (group-I Early Cord Clamping, ECC), ataround 1 minute (group-II Late Cord Clamping, LCC) after birth. The infant's venoushaemoglobin and haematocrit values were measured at 6 hours and 24 to 48 hoursafter birth.Results: 130 mothers were selected for study purpose. Finally 98 were analyzed, 50in early cord clamping group and 48 in late cord clamping group. Mean venoushaemoglobin and haematocrit values at around 6 and 24 to 48 hours of life weremeasured. Results were within physiological limit but difference were significantbetween 2 study groups. The prevalence of anaemia (Hb <14 gm%) was notsignificantly higher in group-I than group-II but relatively more newborns were anaemicin group-I. There was no significant difference in other neonatal outcomes and maternalpostpartum events.Conclusions: Delayed cord clamping at birth increases neonatal venous haemoglobinand haematocrit values within a physiologic range. No harmful effects were observedamong both groups. Furthermore this intervention seems to reduce the incidence ofneonatal anemia. This practice has been shown to be safe and should be practicedto increase neonatal haemoglobin and haematocrit values at birth.Key words: Early cord clamping (ECC); late cord clamping (LCC).DOI: 10.3329/bjch.v33i1.5670Bangladesh Journal of Child Health 2009; Vol.33(1): 16-21

Effect of Delayed Cord Clamping Reduced Anemic Outcome in Preterm Neonate

2021 ◽  
Vol 104 (5) ◽  
pp. 695-700
Keyword(s):  
Intraventricular Hemorrhage ◽  
Preterm Neonate ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
Maternal Outcomes ◽  
Delayed Cord Clamping ◽  
Randomized Controlled ◽  
Cord Clamping ◽  
Significant Difference ◽  
The Mean

Objective: To compare the effects of immediate versus delayed cord clamping on neonatal outcomes in preterm neonates of gestational age of 32 to 36⁺⁶ weeks, and maternal outcomes. Materials and Methods: A randomized controlled trial was conducted in the Obstetrics and Gynecology Department at Bhumibol Adulyadej Hospital, in Bangkok, Thailand. The study compared the effects of immediate to delayed cord clamping at 60 seconds among preterm neonates born between 32 weeks, 0 day and 36 weeks, 6 days of gestation between August and October 2018. Results: The mean age of the participants was 26 years old, and half of the cases were nulliparous. One hundred ten women were randomly separated into two equal groups (n=55). Delayed cord clamping at 60 seconds increased hematocrit levels (Hct) in both two (p=0.004) and 48 (p<0.001) hours after delivery compared to the immediate cord clamping group. There were no differences in exposing the neonate to hypothermia, hypoxemia, Apgar score at 1-minute, polycythemia, intraventricular hemorrhage, hyperbilirubinemia, length of stay in hospital, and affecting the process of resuscitation. There were no statistical differences between the two groups in maternal outcomes such as retained placenta and postpartum hemorrhage. Conclusion: Delayed cord clamping at 60 seconds increased Hct in the newborn at two to 48 hours after birth. There was no significant difference in adverse maternal and neonatal complications within both groups. Keywords: Delayed cord clamping, Hematocrit, Preterm

scholarly journals Comparison of Recovery Time of Propofol and Midazolam with Propofol Alone for Sedation in Endoscopic Retrograde Cholangiopancreatography

2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Recovery Time ◽  
Controlled Trial ◽  
P Value ◽  
Time Data ◽  
Endoscopic Retrograde ◽  
Intravenous Anesthetic ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.

scholarly journals A comparative study of early and delayed cord clamping in term deliveries

2018 ◽  
Vol 7 (12) ◽  
pp. 4929
Author(s):  
Nikita V. Gonnade ◽  
Surendra D. Nikhate ◽  
Himadri Bal ◽  
Nikita Shrivastava
Keyword(s):  
High Risk ◽  
Comparative Study ◽  
Post Partum ◽  
Delayed Cord Clamping ◽  
Cord Clamping ◽  
Select Group ◽  
Early Cord Clamping ◽  
High Risk Factor ◽  
The Difference ◽  
Group B

Background: Timing of clamping of the umbilical cord has always been a debatable issue. Early cord clamping (ECC) is defined as clamping of the cord within 30 seconds of delivery of the baby and delayed cord clamping (DCC) is defined as clamping of the cord between 30 to 120 seconds of delivery. Delayed cord clamping, despite some limitations, is said to be beneficial to the neonate.  A comparative study between ECC and DCC was carried out on a select group of term pregnant women without any high-risk factor and delivering at term. Aim of the study was to compare the effects of early versus delayed cord clamping on neonates and mothers. The focus was on the neonatal haemoglobin levels and adverse effects, if any on neonates and mothers in the two groups.Methods: 100 women satisfying the inclusion/exclusion criteria were recruited for the study. They were randomly divided into two groups of 50 each. Group A underwent early cord clamping and Group B delayed cord clamping. Mothers were observed for 1 hour post-delivery for any evidence of post-partum haemorrhage. Neonates were observed for any sign of tachypnea and blood sample was sent after 72 hours of delivery for analyzing Hb, hematocrit and bilirubin of the neonate.Results: The results revealed that neonates with DCC had a higher mean Hb level of 15.02 vis-à-vis the ECC group Hb of 11.69G/dl and the difference was statistically significant. Similarly mean hematocrit of DCC group was 48.67 while the ECC group mean was 42.36, the difference again was statistically significant. There was no significant side effects or complications in both mother and newborn babies.Conclusions: It was concluded that delayed cord clamping should be practiced in otherwise non high-risk deliveries.

scholarly journals Comparison of early versus standard timing for silicone stent removal following External Dacrocystorhinostomy under local anaesthesia

2019 ◽  
Vol 11 (1) ◽  
pp. 24-28
Author(s):  
Ben Limbu ◽  
Hannah S Lyons ◽  
Mohan Krishna Shrestha ◽  
Geoffrey C Tabin ◽  
Rohit Saiju
Keyword(s):  
Success Rate ◽  
Financial Burden ◽  
Controlled Trial ◽  
Nasolacrimal Duct ◽  
Complication Rates ◽  
Tube Removal ◽  
Significant Difference ◽  
Silicone Stent ◽  
Group A ◽  
Group B

Introduction: The first line treatment for nasolacrimal duct obstruction (NLDO) is external dacrocystorhinostomy (DCR). Following DCR, patients are required to return to Tilganga Institute of Ophthalmology (TIO) six weeks postoperatively for the removal of a silicone stent. As the majority of patients travel large distances at significant cost to reach TIO, most often patients remain within Kathmandu during this six weeks interval. This places a large financial burden on patients. Methods: A randomized controlled trial was designed to compare patient outcomes after early (two weeks postoperatively) versus standard (six weeks postoperatively) removal of silicone stents. 50 selected patients were randomized into two equal groups. Results: At the time of publication, 31 patients (14 in group A and 17 in group B) had completed three months follow up. A success rate of 92.9% was noted in Group A and a success rate of 94.1% observed in group B. No significant difference was found between the two groups for success rate and rate of complications. Conclusion: Early tube removal post DCR appears to cause no significant difference in outcome or complication rates compared to standard tube removal.

Efficacy and Safety of Fenofibrate in Uncomplicated Hyperbilirubinemia in Newborn: A Randomized Trial, with a 6-month Follow-up

2020 ◽  
pp. 37-42
Author(s):  
Jayendra R. Gohil ◽  
Vishal S. Rathod ◽  
Bhoomika D. Rathod
Keyword(s):  
Single Dose ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up. Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods. Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001,  p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period. Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.

Sign in / Sign up

Export Citation Format

Share Document