A Single-Center Experience of Implementing Delayed Cord Clamping in Babies Born at Less Than 33 Weeksʼ Gestational Age

and Children Hospital of Eastern Ontario, Ottawa, Canada (Dr Lacaze-Masmonteil).
Advances in Neonatal Care (Impact Factor: 1.12). 12/2012; 12(6):371-6. DOI: 10.1097/ANC.0b013e3182761246
Source: PubMed


: To describe the implementation and outcomes of delayed cord clamping (DCC) in preterm babies.
: Following staff orientation, a policy of DCC for 45 seconds was instituted for all eligible babies born between 28 and 32 weeks' gestational age, and later to all those younger than 33 weeks.
: Of 480 babies, 349 (73%) were eligible for DCC. Of these, 236 (68%) received DCC. Monthly compliance rates to DCC protocol in eligible babies ranged from 18% to 93%. There was no significant difference in demographic measures or rates of delivery room ventilation between eligible babies who did or did not receive DCC. Delayed cord clamping was associated with less hypothermia, higher initial hemoglobin levels, and less necrotizing enterocolitis, with a trend toward lower 1-minute Apgar scores and less blood pressure support.
: The DCC protocol is feasible in preterm babies with reinforcement and education. It appears practical, safe, and applicable, and has minimal impact on immediate neonatal transition, with possible early neonatal benefits.

46 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Delayed cord clamping is a collaboration between the obstetric team and the neonatal team. Although the optimal timing for clamping the umbilical cord after birth continues to be subject to study, delaying clamping for at least 30-60 seconds, with the newborn held at or below the level of the uterus/placenta supports normal physiology and has proven benefits. Practical issues such as thermoregulation and equipment can be overcome with team collaboration and prebriefing planning. Neonatal nurses who attend deliveries are perfectly poised to influence this practice and improve short- and long-term outcomes for their patients.
    Neonatal network: NN 09/2013; 32(5):369-73. DOI:10.1891/0730-0832.32.5.369
  • [Show abstract] [Hide abstract]
    ABSTRACT: Delayed clamping of the umbilical cord is recommended for term and preterm infants who do not require resuscitation. However, the approach to the newly born infant with signs of fetal compromise, prematurity and extremely low birthweight, or prolonged apnea is less clear. Human and experimental animal data show that delaying the clamping of the umbilical cord until after the onset of respirations promotes cardiovascular stability in the minutes immediately after birth. Rather than regarding delayed cord clamping as a fixed time period before resuscitation begins, a more physiologic concept of transition at birth should encompass the relative timing of onset of respirations and cord occlusion. Further research to explore the potential benefits of resuscitation with the cord intact is needed.
    Seminars in Fetal and Neonatal Medicine 09/2013; 18(6). DOI:10.1016/j.siny.2013.08.008 · 3.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Despite recent advances in perinatal medicine and in the art of neonatal resuscitation, resuscitation strategy and treatment methods in the delivery room should be individualized depending on the unique characteristics of the neonate. The constantly increasing evidence has resulted in significant treatment controversies, which need to be resolved with further clinical and experimental research.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 10/2013; 26 Suppl 2(S2):50-4. DOI:10.3109/14767058.2013.829685 · 1.37 Impact Factor
Show more

Similar Publications