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Cord clamping

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Anup Katheria, Debra Poeltler, Jayson Durham, Jane Steen, Wade Rich, Kathy Arnell, Mauricio Maldonado, Larry Cousins, Neil Finer
OBJECTIVE: To assess whether providing ventilation during delayed cord clamping (V-DCC) increases placental transfusion compared with delayed cord clamping alone (DCC only). STUDY DESIGN: Inborn premature infants (23(0/7)-31(6/7) weeks' gestational age) were randomized to receive at least 60 seconds of V-DCC (initial continuous positive airway pressure) with addition of positive pressure ventilation if needed) or without assisted ventilation (DCC only). For the DCC-only group, infants were dried and stimulated by gently rubbing the back if apneic...
August 26, 2016: Journal of Pediatrics
G T Mandy
No abstract text is available yet for this article.
January 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
H L Ersdal, J Linde, B Auestad, E Mduma, S Lyanga, E Svensen, J Perlman
OBJECTIVES: The optimal timing of cord clamping (CC) in nonbreathing neonates needing stabilisation/resuscitation remains unclear. The objective was to describe the relationship between time to CC, initiation of breathing or positive pressure ventilation (PPV) after stimulation/suction and 24-hour neonatal mortality/morbidity. DESIGN: Observational study. SETTING: A rural Tanzanian referral hospital. POPULATION: Depressed nonbreathing newborns...
July 2016: BJOG: An International Journal of Obstetrics and Gynaecology
David S Allan, Nicholas Scrivens, Tiffany Lawless, Karen Mostert, Lawrence Oppenheimer, Mark Walker, Tanya Petraszko, Heidi Elmoazzen
BACKGROUND: Public banking of umbilical cord blood units (CBUs) containing higher numbers of cells ensures timely engraftment after transplantation for increasing numbers of patients. Delayed clamping of the umbilical cord after birth may benefit some infants by preventing iron deficiency. Implications of delayed cord clamping for public cord blood banking remains unclear. STUDY DESIGN AND METHODS: CBUs collected by Canadian Blood Services at one collection site between November 1, 2014, and March 17, 2015, were analyzed...
March 2016: Transfusion
Patrick D Carroll
Umbilical cord blood is a resource that is available to all neonates. Immediately after delivery of the fetus, cord blood can be used for the direct benefit of the premature infant. Delayed cord clamping and milking of the umbilical cord are 2 methods of transfusing additional fetal blood into the neonate after vaginal or cesarean delivery. Additionally, umbilical cord blood can be utilized for neonatal admission laboratory testing rather than direct neonatal phlebotomy. Together these strategies both increase initial neonatal total blood volume and limit immediate loss through phlebotomy...
September 2015: Clinics in Perinatology
A D Weeks, P Watt, C W Yoxall, A Gallagher, A Burleigh, S Bewley, A M Heuchan, L Duley
OBJECTIVE: Babies receive oxygen through their umbilical cord while in the uterus and for a few minutes after birth. Currently, if the baby is not breathing well at birth, the cord is cut so as to transfer the newborn to a resuscitation unit. We sought to develop a mobile resuscitation trolley on which newly born babies can be resuscitated while still receiving oxygenated blood and the 'placental transfusion' through the umbilical cord. This would also prevent separation of the mother and baby in the first minutes after birth...
April 2015: BMJ Innovations
Roger F Soll, William O Tarnow-Mordi
No abstract text is available yet for this article.
July 2015: Pediatrics
Anup C Katheria, Giang Truong, Larry Cousins, Bryan Oshiro, Neil N Finer
BACKGROUND AND OBJECTIVE: Delayed cord clamping (DCC) is recommended for premature infants to improve blood volume. Most preterm infants are born by cesarean delivery (CD), and placental transfusion may be less effective than in vaginal delivery (VD). We sought to determine whether infants <32 weeks born by CD who undergo umbilical cord milking (UCM) have higher measures of systemic blood flow than infants who undergo DCC. METHODS: This was a 2-center trial. Infants delivered by CD were randomly assigned to undergo UCM or DCC...
July 2015: Pediatrics
A K Yadav, A Upadhyay, S Gothwal, K Dubey, U Mandal, C P Yadav
OBJECTIVE: To compare the effect of combined delayed cord clamping and umbilical cord milking to either of them had done alone, on hematological parameters at 6 weeks of age in term neonates. STUDY DESIGN: It was a randomized controlled trial, conducted during January to December 2014. Three hundred eligible neonates were randomly allocated to three parallel groups. Primary outcome was hemoglobin and serum ferritin at 6 weeks of age. Data were analyzed using analysis of variance and Kruskal-Wallis test...
September 2015: Journal of Perinatology: Official Journal of the California Perinatal Association
Kristina S Sobotka, Graeme R Polglase, Georg M Schmölzer, Peter G Davis, Claus Klingenberg, Stuart B Hooper
BACKGROUND: Chest compressions (CC) and adrenaline administration are recommended in asphyxiated newborns with persistent bradycardia despite effective ventilation. The effects of CC on cerebral blood flow in newborns at birth are unknown. Our aim was to determine the effects of CC, with or without adrenaline administration, on the return of spontaneous circulation, carotid blood flow (CBF), and carotid arterial pressure (CAP) in asphyxiated near-term lambs. METHODS: Asphyxia was induced in near-term lambs by clamping the umbilical cord and delaying ventilation onset until spontaneous circulation ceased...
October 2015: Pediatric Research
Ola Andersson, Barbro Lindquist, Magnus Lindgren, Karin Stjernqvist, Magnus Domellöf, Lena Hellström-Westas
IMPORTANCE: Prevention of iron deficiency in infancy may promote neurodevelopment. Delayed umbilical cord clamping (CC) prevents iron deficiency at 4 to 6 months of age, but long-term effects after 12 months of age have not been reported. OBJECTIVE: To investigate the effects of delayed CC compared with early CC on neurodevelopment at 4 years of age. DESIGN, SETTING, AND PARTICIPANTS: Follow-up of a randomized clinical trial conducted from April 16, 2008, through May 21, 2010, at a Swedish county hospital...
July 2015: JAMA Pediatrics
Elizabeth Nevill, Michael P Meyer
BACKGROUND: The effects of delayed cord clamping (DCC) on transition in preterm infants are important as this procedure is becoming increasingly recommended. The aim of this study was to compare the effects of DCC with an historical cohort. METHOD: In this observational study, outcomes for infants ≤ 29 weeks were compared with a group born before the introduction of DCC. The intended intervention was DCC for 40s. Primary outcomes were the need for resuscitation and intubation in infants undergoing DCC, whilst taking note of their breathing during the procedure...
July 2015: Early Human Development
Martin Kluckow, Stuart B Hooper
Immediate clamping and cutting of the umbilical cord at birth has been the accepted standard of care for decades. The physiologic rationale relating umbilical cord clamping (UCC) to the events of the circulatory transition is not considered in arbitrarily recommended cord clamping times. Systematic review of early versus deferred UCC shows significant hemodynamic benefits to the deferred group. Mechanisms for this protective effect are considered in this review. The original concept of a placental transfusion with a volume load and prevention of low cardiac output relies on the physiological end point of the amount of blood transfused...
August 2015: Seminars in Fetal & Neonatal Medicine
Marrit Smit, Jennifer A Dawson, Angelina Ganzeboom, Stuart B Hooper, Jos van Roosmalen, Arjan B te Pas
OBJECTIVE: To assess whether defined reference ranges of oxygen saturation (SpO₂) and heart rate (HR) of term infants after birth also apply for infants born after midwifery supervised uncomplicated vaginal birth, where delayed cord clamping (DCC) and immediate skin to skin contact (ISSC) is routine management. DESIGN: Prospective observational study. SETTING AND PATIENTS: Infants born vaginally after uncomplicated birth, that is, no augmentation, maternal pain relief or instrumental delivery...
July 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
E S Ogata, J A Kitterman, F Kleinberg, L Dong, M Willis, J Mates, R H Phibbs
We measured the residual placental blood volume (RPBV) of 20 infants delivered at term by cesarean section of women not in labor. In all cases, the umbilical cord was clamped within 40 seconds of birth. RPBV decreased significantly with increasing age at cord clamping. In addition, RPBV for infants with cords clamped within 20 seconds of birth correlated inversely with maternal systolic blood pressure (mean RPBV = 54.8 ml. per kilogram at 105 torr and 28.4 ml. per kilogram at 148 torr). However, RPBV did not correlate with maternal blood pressure for the whole group of 20 infants or for those with cords clamped later than 20 seconds after birth...
May 15, 1977: American Journal of Obstetrics and Gynecology
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