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

Author:

Bierut Tatiana1,Conner Shayna1,Tuuli Methodius1,Vesoulis Zachary2,Macones George1,Cahill Alison1,Rhoades Janine1

Affiliation:

1. Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri

2. Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri

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.

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynaecology,Pediatrics, Perinatology, and Child Health

Cited by 4 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Cord management strategies in multifetal gestational births;Seminars in Perinatology;2023-06

2. Implementation of Delayed Cord Clamping in public health facilities: a case study from India;BMC Pregnancy and Childbirth;2022-06-01

3. Delayed cord clamping: Impact on fetal cord blood gas analysis;Australian and New Zealand Journal of Obstetrics and Gynaecology;2022-02-07

4. Implementation and Outcomes of Universal Delayed Umbilical Cord Clamping at Term;American Journal of Perinatology;2018-09-12

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