Delayed Umbilical Cord Clamping Flashcards
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. In preterm infants, rates of intraventricular hemorrhage and necrotizing enterocolitis are lower, and fewer newborns require transfusion when delayed umbilical cord clamping is employed.
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However, because the placenta continues to perform gas exchange after delivery, sick and preterm infants are likely to benefit most from additional blood volume derived from continued placental transfusion. Another concern is that a delay in umbilical cord clamping could increase the potential for excessive placental transfusion. To date, the literature does not show evidence of an increased risk of polycythemia or jaundice; however, in some studies there is a slightly higher rate of jaundice that meets criteria for phototherapy in term infants. Given the benefits to most newborns and concordant with other professional organizations, the American College of Obstetricians and Gynecologists now recommends a delay in umbilical cord clamping for at least 30–60 seconds after birth in vigorous term and preterm infants.
Neonatal Outcomes
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The effect of delayed umbilical cord clamping on umbilical cord blood collection for banking recently has been evaluated in a public umbilical cord blood bank setting (30). The authors found that delayed umbilical cord clamping significantly decreased the volume and total nucleated cell counts of cord blood donations
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delayed umbilical cord clamping for at least 30–60 seconds is recommended in term and preterm infants except when immediate umbilical cord clamping is necessary because of neonatal or maternal indications. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice requiring phototherapy in term infants undergoing delayed umbilical cord clamping. Consequently, obstetrician–gynecologists and other obstetric care providers adopting delayed cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice.
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Similarly, evidence also supports delayed umbilical cord clamping for at least 30–60 seconds in preterm infants. Delayed umbilical cord clamping is associated with significant neonatal benefits in preterm infants, including improved transitional circulation, better establishment of red blood cell volume, decreased need for blood transfusion, and lower incidence of necrotizing enterocolitis and intraventricular hemorrhage.
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