Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2018 May 4;18(1):131.
doi: 10.1186/s12884-018-1781-6.

Maternal bleeding complications following early versus delayed umbilical cord clamping in multiple pregnancies

Chayatat Ruangkit  1 , Matthew Leon  2 , Kasim Hassen  2 , Katherine Baker  2 , Debra Poeltler  2 , Anup Katheria  3
Affiliations
Comparative Study

Maternal bleeding complications following early versus delayed umbilical cord clamping in multiple pregnancies

Chayatat Ruangkit et al. BMC Pregnancy Childbirth. .

Abstract

Background: In 2015, the American Academy of Pediatrics recommended delayed umbilical cord clamping for at least 30-60 s for all infants. However, there is limited data regarding the maternal safety of delayed cord clamping in multiple pregnancies. We aimed to compare the maternal bleeding complications following early cord clamping (ECC) versus of delayed cord clamping (DCC) in multiple pregnancies.

Methods: A retrospective cohort study of pregnant women with multiples who delivered live-born infants at Sharp Healthcare Hospitals in San Diego, CA, USA during January 1st, 2016 - September 30th, 2017. Bleeding complications of 295 women who underwent ECC (less than 30 s) were compared with 154 women who underwent DCC (more than 30 s). ECC or DCC was performed according to individual obstetrician discretion.

Results: Four hundred forty-nine women with multiple pregnancies (N = 910 infants) were included in the study. 252 (85.4%) women underwent cesarean section in ECC group vs. 99 (64.3%) in DCC group. 58 (19.7%) women delivered monochorionic twins in ECC group vs. 32 (20.8%) women in DCC group. There was no increase in maternal estimate blood loss when DCC was performed comparing to ECC. There were no differences in operative time, post-delivery decrease in hematocrits, rates of postpartum hemorrhage, bleeding complications, maternal blood transfusions and therapeutic hysterectomy between the two groups.

Conclusions: No differences in maternal bleeding complications were found with DCC in multiple pregnancies compared to ECC. Delayed cord clamping can be done safely in multiple pregnancies without any increased maternal risk.

Keywords: Delayed umbilical cord clamping; Multiple pregnancy; Postpartum hemorrhage.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by Sharp Mary Birch Hospital for Women & Newborns Human Research Protection Office, IRB No. 1712804. Waiver of individual patient informed consent was granted.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of patients in the study
See this image and copyright information in PMC

References

    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;8:CD003248. - PubMed
    1. Mcdonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev. 2013;7:CD004074. - PMC - PubMed
    1. Bhatt S, Alison BJ, Wallace EM, et al. Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs. J Physiol. 2013;591(8):2113–2126. doi: 10.1113/jphysiol.2012.250084. - DOI - PMC - PubMed
    1. Andersson O, Lindquist B, Lindgren M, Stjernqvist K, Domellöf M, Hellström-westas L. Effect of delayed cord clamping on neurodevelopment at 4 years of age: a randomized clinical trial. JAMA Pediatr. 2015;169(7):631–638. doi: 10.1001/jamapediatrics.2015.0358. - DOI - PubMed
    1. Fogarty M, Osborn DA, Askie L, et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017; [Epub ahead of print] - PubMed

Publication types