Delayed umbilical cord clamping in preterm infants: A feasibility study

Objectives: To assess: (i) the size of placental transfusion following a 30 s delay in cord clamping following vaginal and Caesarean births; and (ii) the feasibility of delaying cord clamping in the labour ward and particularly in the operating theatre. Methods: Fourty‐six infants born at 26–33 week...

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Bibliographic Details
Published in:Journal of paediatrics and child health 1997-08, Vol.33 (4), p.308-310
Main Authors: McDONNELL, M, HENDERSON-SMART, DJ
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Transfusion, Intrauterine
Caesarean
Cesarean Section - methods
Chi-Square Distribution
Constriction
Delivery. Postpartum. Lactation
Feasibility Studies
Female
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
Infant, Newborn
Infant, Premature
Male
Medical sciences
Natural Childbirth - methods
Obstetrical techniques
Pregnancy
preterm infants
Time Factors
Treatment Outcome
umbilical clamping
Umbilical Cord
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Summary:Objectives: To assess: (i) the size of placental transfusion following a 30 s delay in cord clamping following vaginal and Caesarean births; and (ii) the feasibility of delaying cord clamping in the labour ward and particularly in the operating theatre. Methods: Fourty‐six infants born at 26–33 weeks gestation were randomized to having the umbilical cord clamped either immediately or 30 s after birth. The venous haematocrit was measured at 1 and at 4 h of age. Results: There were trends towards higher mean haematocrits in the infants following delayed clamping, but these were not significant either at 1 h (55±7.7 vs 52.9±7) or at 4 h of age (55±7 vs 52.5±7). The trends were more marked in the infants born by Caesarean section, and in those born at 26–29 weeks gestation. Conclusions: A 30 s delay in cord clamping is feasible at both vaginal and Caesarean births, but does not lead to the predicted difference in infant haematocrit. Although physiological studies suggest that a placental transfusion of 15–20 mL/kg occurs within 30 s of delivery, these data suggest that future trials should either delay cord clamping for more than 30 s, or should alter the position of the infant in relation to the uterus in order to facilitate the transfusion. Delayed cord clamping is feasible at Caesarean section.
ISSN:1034-4810
1440-1754
DOI:10.1111/j.1440-1754.1997.tb01606.x