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. 2017 Sep;34(11):1048-1053.
doi: 10.1055/s-0037-1603591. Epub 2017 May 25.

Delayed Umbilical Cord Clamping at <32 Weeks' Gestation: Implementation and Outcomes

Janine S Rhoades  1 , Tatiana Bierut  1 , Shayna N Conner  1 , Methodius G Tuuli  1 , Zachary A Vesoulis  2 , George A Macones  1 , Alison G Cahill  1
Affiliations

Delayed Umbilical Cord Clamping at <32 Weeks' Gestation: Implementation and Outcomes

Janine S Rhoades et al. Am J Perinatol. 2017 Sep.

Abstract

Objectives: This study aims to evaluate the implementation of a delayed umbilical cord clamping (DCC) protocol for neonates <32 weeks. Secondarily, to evaluate the impact of DCC on maternal outcomes and on the ability to obtain umbilical cord blood gases.

Study Design: Retrospective cohort study from November 2014 to March 2016 of patients delivered by 316/7 weeks. In 2014, an institutional protocol for DCC at <32 weeks was implemented. We assessed adherence to the protocol and compared adverse maternal outcomes (utilizing a hemorrhage composite). We evaluated the impact of DCC on the ability to obtain adequate umbilical cord blood gas specimens.

Results: Of the 185 patients included in the study, 90 underwent DCC, and 72% of potentially eligible patients appropriately received DCC. There was no significant difference in the maternal hemorrhage composite outcome between DCC and immediate cord clamping (23.3 vs. 36.8%, adjusted odds ratio = 0.64, 95% confidence interval = 0.33, 1.26). There was also no significant difference in the ability to obtain a single or paired umbilical cord blood gas result.

Conclusion: Implementation of a DCC protocol for preterm neonates is feasible and was successful. We did not find an increase in maternal risk or a decrease in the ability to obtain umbilical cord blood gases following DCC.

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Conflict of interest statement

Conflict of Interest: None.

Figures

Fig. 1
Fig. 1
Flowchart of study cohort.
See this image and copyright information in PMC

References

    1. Aladangady N, McHugh S, Aitchison TC, Wardrop CA, Holland BM. Infants’ blood volume in a controlled trial of placental transfusion at preterm delivery. Pediatrics. 2006;117(01):93–98. - PubMed
    1. Rabe H, Diaz-Rossello JL, Duley L, Dowswell T. 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;(08):CD003248. doi: 10.1002/14651858.CD003248.pub3. - DOI - PubMed
    1. Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W. Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics. 2006;117(04):1235–1242. - PMC - PubMed
    1. Kinmond S, Aitchison TC, Holland BM, Jones JG, Turner TL, Wardrop CA. Umbilical cord clamping and preterm infants: a randomised trial. BMJ. 1993;306(6871):172–175. - PMC - PubMed
    1. Rabe H, Wacker A, Hülskamp G, et al. A randomised controlled trial of delayed cord clamping in very low birth weight preterm infants. Eur J Pediatr. 2000;159(10):775–777. - PubMed