Barriers to deferred cord clamping in preterm infants
- PMID: 24903454
- PMCID: PMC4145419
- DOI: 10.1136/archdischild-2014-305968
Barriers to deferred cord clamping in preterm infants
Abstract
Objectives: To describe the range of practices employed by units conducting deferred cord clamping at very preterm birth.
Design: Qualitative study using semistructured interviews with neonatal doctors, nurses, midwives, obstetricians and managers in a sample of UK maternity units.
Participants: 33 neonatal doctors, neonatal nurses, midwives, obstetricians and managers.
Setting: UK maternity units in 2012.
Results: Four key themes emerged. The first concerns the variation in guideline content, the absence of a practice of stabilisation with cord intact, and issues with implementing and maintaining changes in practice. The second concerns the challenges in assessing eligibility. The third concerns the competing priorities of delivering the intervention and proceeding with other stabilisation manoeuvres and the associated anxiety experienced by professionals. The final theme relates to the issue of uncertainty as to optimal treatment choices.
Conclusions: The evidence surrounding deferred cord clamping in very preterm infants is unclear. This study describes the reported practice of units deferring cord clamping in 2012 and will inform trial development.
Keywords: Neonatology; Qualitative Research; Resuscitation.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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- Rabe H, Diaz-Rossello JL, Duley L, et al. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev 2012;(8):CD003248. - PubMed
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