Delayed umbilical cord clamping after childbirth: potential benefits to baby's health

Published on Nov 14, 2014in Pediatric Health, Medicine and Therapeutics
· DOI :10.2147/PHMT.S51867
Christina Uwins4
Estimated H-index: 4
,
David Jr Hutchon2
Estimated H-index: 2
Sources
Abstract
Early cord clamping was initially introduced as part of the package of care known as "active management of the third stage", which was implemented to reduce postpartum hemorrhage. It has now been shown to provide no benefit to the mother and to result in harm to the neonate. The clinical trial evidence relating to delayed cord clamping compared to immediate cord clamping is presented and the physiological rationale for delayed cord clamp- ing is discussed in this paper. Most organizations (eg World Health Organization (WHO), Royal College of Obstetricians and Gynaecologists (RCOG), Resuscitation Council (UK),The International Federation of Gynecology and Obstetrics (FIGO), International Confederation of Midwives, International Liaison Committee on Resuscitation (ILCOR) and the European Resuscitation Council) now advise a delay of 1-3 minutes before clamping the cord in term and preterm infants, and clinicians need to be aware of this change. Healthy neonates benefit from a more physiological and gentle transition from placental to pulmonary respiration, and we explain why this benefit should be provided to all neonates until there is any evidence to the contrary. The harm of early cord clamping is not limited to anemia and iron deficiency, and evidence for a wide range of possible harms of early cord clamping is presented. The need for resuscitation is one of the most common concerns, and ways of overcoming these concerns are described.
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Deferring cord clamping has proven benefits for both term and preterm infants, and recent studies have demonstrated better cardio-respiratory stability if clamping is based on the infant’s physiology, and whether the infant has breathed. Nevertheless, current guidelines for neonatal resuscitation still recommend early cord clamping (ECC) for compromised babies, unless equipment and competent personnel to resuscitate the baby are available at the mother’s bedside. The objective of this quality im...
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In human neonates, when the umbilical cord is kept intact postpartum, blood continues to flow to the neonate, but this procedure might be difficult in dogs owing to a shorter umbilical cord and several neonates in a litter. However, it might be possible to detach the placenta and keep the umbilical cord intact, allowing residual blood to flow to the puppies. This study compared the effects of clamping versus no clamping of the umbilical cord in dogs born by cesarean section on neonatal vitality....
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Background: Delaying umbilical cord 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. Early clamping allows for immediate transfer of the infant to the neonatologist. Objectives: to assess the knowledge of nurse – midwives about early ...
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The heart rate of a neonate at birth is used to determine whether or not resuscitation is required. The normal healthy range of heart rate is not well established and the method for determining the heart rate is often unreliable and undocumented in the first minute or so after birth. The reasons for the poorly established heart rate norms are discussed and the solution for reliable measurement and documentation of the neonatal heart rate immediately after birth is presented.
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