scholarly journals A Feasibility Study of a Novel Delayed Cord Clamping Cart

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 357
Author(s):  
Neha S. Joshi ◽  
Kimber Padua ◽  
Jules Sherman ◽  
Douglas Schwandt ◽  
Lillian Sie ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Neonatal Resuscitation ◽  
Low Risk ◽  
Professional Organizations ◽  
Deficiency Anemia ◽  
Delayed Cord Clamping ◽  
Team Members ◽  
Cord Clamping ◽  
Umbilical Cord Clamping ◽  
Term Newborns

Delaying umbilical cord clamping (DCC) for 1 min or longer following a neonate’s birth has now been recommended for preterm and term newborns by multiple professional organizations. DCC has been shown to decrease rates of iron deficiency anemia, intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and blood transfusion. Despite these benefits, clinicians typically cut the umbilical cord without delay in neonates requiring resuscitation and move them to a radiant warmer for further care; this effectively prevents these patients from receiving any benefits from DCC. This study evaluated the feasibility of a delayed cord clamping cart (DCCC) in low-risk neonates born via Cesarean section (CS). The DCCC is a small, sterile cart designed to facilitate neonatal resuscitation while the umbilical cord remains intact. The cart is cantilevered over the operating room (OR) table during a CS, allowing the patient to be placed onto it immediately after birth. For this study, a sample of 20 low-risk CS cases were chosen from the non-emergency Labor and Delivery surgical case list. The DCCC was utilized for 1 min of DCC in all neonates. The data collected included direct observation by research team members, recorded debriefings and surveys of clinicians as well as surveys of patients. Forty-four care team members participated in written surveys; of these, 16 (36%) were very satisfied, 12 (27%) satisfied, 13 (30%) neutral, and 3 (7%) were somewhat dissatisfied with use of the DCCC in the OR. Feedback was collected from all 20 patients, with 18 (90%) reporting that they felt safe with the device in use. This study provides support that utilizing a DCCC can facilitate DCC with an intact umbilical cord.

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 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

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 Pemerahan dan penundaan penjepitan tali pusat terhadap kadar hemoglobin bayi baru lahir

2018 ◽  
Vol 5 (3) ◽  
pp. 195-200
Author(s):  
Ahmaniyah Ahmaniyah ◽  
Kamilah Hidajati ◽  
Ari Suwondo
Keyword(s):  
Treatment Group ◽  
Umbilical Cord ◽  
Vascular System ◽  
Sampling Technique ◽  
Deficiency Anemia ◽  
Control Group ◽  
Delayed Cord Clamping ◽  
Term Infants ◽  
Cord Clamping ◽  
Umbilical Cord Milking

The incidence of iron deficiency anemia in term infants from 0-6 months is 40.8%. Efforts to reduce anemia in infants and toddlers is by ensuring the baby gets blood from the placenta through the umbilical cord. Labor occurs when oxygen shifts from the heart to the lungs 8-10% of the fetal period to 50% in neonates. Immediate cord clamping vascular resistance from the disconnected placenta which results in the increased of resistance of the baby's vascular system and eliminates about 1/4 of the volume of blood and iron in the neonate. The time of cutting the umbilical cord is a determining factor for placental transfusion to the baby. Delay cord clamping and umbilical cord milking are expected to provide iron reserves in infant. The aim of this study was to determine the differences in umbilical cord milking and delayed cord clamping. The design used experimental study with posttest-Only Control Group. The sampling technique used simple random sampling differs into treatment group and control group. The treatment group was umbilical cord milking and the control group was delayed cord clamping. The highest average of Hb levels in the umbilical cord milking group was 17.3mmHg and the delayed cord clamping group was 15.75 mmHg. Difference test on umbilical cord milking group and delayed cord clamping group used independent T-test obtained P <0.05 (p = 0,001). It is recommended that midwives used umbilical cord milking as an alternative action in providing midwifery care to newborns when clamping and cutting the umbilical cord. It was proven that there were differences in the haemoglobin levels of newborns between the umbilical cord milking group and delayed cord clamping group.

scholarly journals Neonatal Resuscitation with an Intact Cord: Current and Ongoing Trials

Children ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 60 ◽  
Author(s):  
Anup C. Katheria
Keyword(s):  
Clinical Trials ◽  
High Risk ◽  
Umbilical Cord ◽  
Intraventricular Hemorrhage ◽  
Neonatal Resuscitation ◽  
Research Setting ◽  
Delayed Cord Clamping ◽  
Term Infants ◽  
Cord Clamping ◽  
Ischemic Encephalopathy

Premature and full-term infants are at high risk of morbidities such as intraventricular hemorrhage or hypoxic-ischemic encephalopathy. The sickest infants at birth are the most likely to die and or develop intraventricular hemorrhage. Delayed cord clamping has been shown to reduce these morbidities, but is currently not provided to those infants that need immediate resuscitation. This review will discuss recently published and ongoing or planned clinical trials involving neonatal resuscitation while the newborn is still attached to the umbilical cord. We will discuss the implications on neonatal management and delivery room care should this method become standard practice. We will review previous and ongoing trials that provided respiratory support compared to no support. Lastly, we will discuss the implications of implementing routine resuscitation support outside of a research setting.

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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