Document Detail


Early versus delayed cord clamping in term and preterm births: a review.
MedLine Citation:
PMID:  22673168     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The optimal timing for cord clamping, early versus delayed, in the third stage of labour is a controversial subject. Issues surrounding the timing of cord clamping include gestational age and maternal and neonatal considerations. Delayed cord clamping (DCC) has been shown to increase placental transfusion, leading to an increase in neonatal blood volume at birth of approximately 30%. In the term infant, although this may result in an increase in iron stores, thereby decreasing the risk of anemia, it may adversely increase the risk of jaundice and the need for phototherapy. In the preterm infant, DCC (or even milking of the cord) decreases the need for blood transfusions for anemia, the number of such transfusions, and the risks of intraventricular hemorrhage and late-onset sepsis. Advantages of DCC also include a reduction in alloimmunization in Rh-negative women, although this advantage is theoretical and unproven. We searched multiple databases including PubMed Clinical Queries, Trip Database, Cochrane Systematic Reviews, and UpToDate, as well as published guidelines from the Society of Obstetricians and Gynaecologists of Canada, the American Congress of Obstetricians and Gynecologists, and the Royal College of Obstetricians and Gynaecologists. We preferentially selected systematic reviews and randomized controlled trials for this literature review. Overall, the available evidence appears to suggest that DCC is likely to result in better neonatal outcomes in both term and preterm infants, even in areas where neonatal iron deficiency anemia is rare. However, there is insufficient evidence to date to support a recommendation to delay cord clamping in non-vigorous infants requiring resuscitation.
Authors:
Milena Garofalo; Haim A Abenhaim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC     Volume:  34     ISSN:  1701-2163     ISO Abbreviation:  J Obstet Gynaecol Can     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101126664     Medline TA:  J Obstet Gynaecol Can     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  525-31     Citation Subset:  IM    
Affiliation:
McGill University, Faculty of Medicine, Montreal QC.
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