Effects of Different Techniques of Cord Clamping on Neonatal Outcome in Preterm Births
Yasmine Samy Mostafa Hassan El Sadany;
Abstract
ptimal timing for clamping the umbilical cord at preterm birth is unclear. Early clamping allows for immediate transfer of the infant to the neonatologist. Delaying clamping allows blood flow between the placenta, the umbilical cord and the baby to continue. The blood which transfers to the baby between birth and cord clamping is called placental transfusion. Placental transfusion may improve circulating volume at birth, which may in turn improve outcome for preterm infants.
Delayed cord clamping has been associated with increased placenta-to-neonate transfusion, leading to an increase in neonatal blood volume at birth. This increases iron stores and hemoglobin concentration, decreasing in the risk of anemia, intraventricular hemorrhage and necrotizing enterocolitis.
On the other hand, milking of the umbilical cord four times within 10 to 12 seconds seems to be as effective in terms of placental transfusion as delaying cord clamping. However, this observation is based on one randomized controlled trial in the preterm population only.
The aim of the work is to compare early versus delayed cord clamping with and without milking of the cord in cases of preterm births.
The study was conducted between November 2012 and October 2013 at Ain Shams University Maternity and Women’s Hospital, and included 150 women, gestational age ranged from 32 to 36 weeks; participants were randomized into 6 groups, Group 1: women were assigned to early cord clamping where the umbilical cord was clamped just after delivery within 5 seconds; Group 2: women were assigned to milking of the umbilical cord 4 times before cutting; Group 3: women were assigned to delayed umbilical cord clamping up at 30 to 45 seconds from birth before cutting of the cord; Group 4: women were assigned to delayed umbilical cord clamping at 30 to 45 seconds from birth with milking of the cord 4 times before cutting it; Group 5: women were assigned to delayed umbilical cord clamping at 45 to 60 seconds from birth before cutting of the cord; Group 6: women were assigned to delayed umbilical cord clamping at 45 to 60 seconds from birth with milking of the cord four times before cutting it.
In this current study we found that a slight delay in cord clamping(30 to 45 seconds) or milking of the cord four times as in groups II and III were associated with higher hemoglobin levels higher HCT values, fewer infants requiring transfusions for anemia, less intraventricular hemorrhage (ultrasound diagnosis all grades) and lower risk for necrotising enterocolitis compared with immediate clamping. However, the peak bilirubin concentration was higher with high significant statistical difference for infants allocated to very late cord clamping compared with immediate clamping, there was no significant
Delayed cord clamping has been associated with increased placenta-to-neonate transfusion, leading to an increase in neonatal blood volume at birth. This increases iron stores and hemoglobin concentration, decreasing in the risk of anemia, intraventricular hemorrhage and necrotizing enterocolitis.
On the other hand, milking of the umbilical cord four times within 10 to 12 seconds seems to be as effective in terms of placental transfusion as delaying cord clamping. However, this observation is based on one randomized controlled trial in the preterm population only.
The aim of the work is to compare early versus delayed cord clamping with and without milking of the cord in cases of preterm births.
The study was conducted between November 2012 and October 2013 at Ain Shams University Maternity and Women’s Hospital, and included 150 women, gestational age ranged from 32 to 36 weeks; participants were randomized into 6 groups, Group 1: women were assigned to early cord clamping where the umbilical cord was clamped just after delivery within 5 seconds; Group 2: women were assigned to milking of the umbilical cord 4 times before cutting; Group 3: women were assigned to delayed umbilical cord clamping up at 30 to 45 seconds from birth before cutting of the cord; Group 4: women were assigned to delayed umbilical cord clamping at 30 to 45 seconds from birth with milking of the cord 4 times before cutting it; Group 5: women were assigned to delayed umbilical cord clamping at 45 to 60 seconds from birth before cutting of the cord; Group 6: women were assigned to delayed umbilical cord clamping at 45 to 60 seconds from birth with milking of the cord four times before cutting it.
In this current study we found that a slight delay in cord clamping(30 to 45 seconds) or milking of the cord four times as in groups II and III were associated with higher hemoglobin levels higher HCT values, fewer infants requiring transfusions for anemia, less intraventricular hemorrhage (ultrasound diagnosis all grades) and lower risk for necrotising enterocolitis compared with immediate clamping. However, the peak bilirubin concentration was higher with high significant statistical difference for infants allocated to very late cord clamping compared with immediate clamping, there was no significant
Other data
| Title | Effects of Different Techniques of Cord Clamping on Neonatal Outcome in Preterm Births | Other Titles | تأثيرات التقنيات المختلفة لعملية لقط الحبل السرى على حديثى الولادة فى حالات الولادة المبتسرة | Authors | Yasmine Samy Mostafa Hassan El Sadany | Issue Date | 2014 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.