A STUDY ON ATTITUDE, BEHAVIOR AND UMBILICAL CORD CLAMPING ON NEONATAL JAUNDICE IN PREGNANCY: TREATMENT APPROACHES AFTER PARTURITION

Author(s):  
Nitin Sharadchandra Gupte ◽  
Suvarna Nitin Gupte

The aim of the present study was to investigate cord clamping practice and treatment approaches for term vaginal births in Indian hospital, where the majority of births have an Obstetrician as the lead. A stopwatch was used to time the cord clamping interval at 55 term vaginal births in a tertiary hospital. The stopwatch was pressed once at the time of the birth and once when the first clamp was applied to the umbilical cord. Mode of birth, maternal position for birth and whether midwives and or doctors and neonatal health practitioners were involved in the birth was documented alongside the cord clamping timing. Cord clamping timing ranged from a minimum of 14 seconds to a maximum of 34 minutes.  The median umbilical cord clamping time for all births in the study was 3.5 minutes.  The median cord clamping time was likely to be longer when the woman had a spontaneous vaginal birth rather than an instrumental birth; when she birthed in a side-lying or upright position rather than a seated position; when a midwife facilitated the birth rather than a doctor and when there was no neonatal team present at the birth. The median cord clamping time of 3.5 minutes is aligned with current local, national and international guidelines.  Midwives are likely to facilitate longer cord clamping times as they are more likely than doctors to attend spontaneous uncomplicated births which do not warrant immediate separation of mother and baby for preventative or resuscitative measures. Keywords: Resuscitative measures, Cord clamping, Spontaneous vaginal birth, Behavior and Umbilical Cord Clamping, Neonatal Jaundice

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Viktoria Nelin ◽  
Ashish KC ◽  
Ola Andersson ◽  
Nisha Rana ◽  
Mats Målqvist

2020 ◽  
Vol 142 ◽  
pp. 104948 ◽  
Author(s):  
Yiyu Qian ◽  
Qiujing Lu ◽  
Hailing Shao ◽  
Xinxin Ying ◽  
Wenle Huang ◽  
...  

Author(s):  
Narcizo Leopoldo Eduardo Da Cunha Sobieray ◽  
Izabelle Schermak das Neves ◽  
Thayná Skrobot

O Objetivo deste estudo foi analisar a relação entre o tempo de clampeamento do cordão umbilical e incidência de Icterícia Neonatal e níveis de hematócrito em RN a termo saudáveis em uma maternidade de baixo risco em Curitiba de abril de 2015 a março de 2016. Métodos: Foram analisados prontuários de 188 RN, obtendo informações como via de parto, tempo de clampeamento e descrição de icterícia nos RN. Em 92 destes, foram coletadas amostras de sangue por capilaridade para avaliação dos níveis de hematócrito. Estabeleceu-se como clampeamento precoce aquele realizado antes dos 60 segundos e tardio os realizados em um tempo maior ou igual a 60 segundos. Resultados: Observou-se icterícia em 25% dos RN. A média do tempo de clampeamento do grupo sem icterícia foi 105 segundos em comparação com 108 segundos no grupo com icterícia, sem associação significante (p = 0,068) O risco relativo de um RN clampeado tardiamente apresentar icterícia foi 2,18 vezes maior do que em um RN clampeado precocemente (RR=2,18 IC 95% 0,15-1,71). Quanto aos níveis de hematócrito realizados, no grupo de clampeamento tardio o valor médio foi de 58,05% e 09 destes apresentaram valores > 65,0%. No grupo de clampeamento precoce não houve níveis de hematócrito > 65%. Conclusão: A média do tempo de clampeamento dos grupos foi bastante similar, o que não nos permitiu concluir que RN com maior tempo de clampeamento apresentaram mais icterícia. No entanto, o risco relativo foi maior para esta situação. Os níveis de hematócrito foram maiores no grupo com clampeamento tardio. Outros estudos são necessários para se avaliar o impacto na prevenção de Anemia no lactente.Descritores: Cordão umbilical, Icterícia neonatal, Anemia, Hiperbilirrubinemia, Recém-nascido Abstract Purpose: The objective of this study was to analyze the relationship between umbilical cord clamping time and incidence of Neonatal Jaundice and hematocrit levels in healthy term newborns (NB) in a low-risk maternity hospital in Curitiba, from April of 2015 to march of 2016.  Methods: We analyzed charts of 188 NB, obtaining information such as the way of delivery, clamping time and description of jaundice in NB. In 92 of these, capillary blood samples were collected for evaluation of hematocrit levels. It was established as an early clamping that performed before 60 seconds and late that performed in a time greater than or equal to 60 seconds. Results: Jaundice was observed in 25% of NB. The mean clamping time of the non-jaundiced group was 105 seconds compared to 108 seconds in the jaundiced group., without significant association (p = 0,068). The relative risk of a late-clamped NB presenting jaundice was 2.18 times greater than in an early clamping (RR = 2.18, 95% CI, 0.15-1.71). As for hematocrit levels, the mean value of late clamping group was 58.05% and 09 of these presented values > 65.0%. In the early clamping group there were no levels of hematocrit > 65%.Conclusion: The mean  clamping time of the groups was quite similar, which did not allow us to conclude that NB with a longer clamping time had more jaundice. However, the relative risk was increased for this situation.  Hematocrit levels were higher in the late clamping group. Other studies are necessary to evaluate the impact on the prevention of anemia in the infant.Key-words:   Umbilical cord; Neonatal jaundice; Anemia; Hyperbilirubinemia; Infant, newborn


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