English

Abstract

AIM: To study the relationship of timing of cord clamping to the hematocrit and hemoglobin values within 0- 6 hours of life - comparison in term normal vaginal delivery to cesarean delivery. Clamping and cutting of the umbilical cord at birth is by far the oldest and most prevalent intervention in humans. In spite of that the optimal time of cord clamping has been a controversial issue for decades. There are no formal practice guidelines as such but practitioners in western countries clamp and cut the cord immediately after birth while the practice worldwide is variable. OBJECTIVE: To study and observe the effect of timing of cord clamping on neonatal hematocrit and hemoglobin within 0 - 6 hours of life & compare in term normal vaginal delivery to cesarean delivery. METHODS: This is a randomized, control trial conducted in the Dept. of Pediatrics and Dept. of Gyn & Obst., Mahatma Gandhi Medical College & hospital. Jaipur, between 20 th to 30 th September 2013. Patients admitted in labor ward were selected according to the inclusion criteria of the study. Group A included 50 term normal vaginal delivery babies in whom the time of cord clamp from birth was noted and a cord blood or venous blood of baby was send within 6 hours of life for estimation of hematocrit & hemoglobin values, while group B included 50 term babies born via cesarean section and same procedure was followed. RESULTS: It was observed that delayed cord clamping (at 1 or 2 minutes after birth) in healthy term newborns increases hematocrit & hemoglobin value within physiologic ranges without causing any harmful effects. Umbilical cord clamping at 1 minute of life increases hematocrit in no more than much 8- 10 points compared with cord clamping in first 15 seconds after birth. As per normal practice of early cord clamping in Indian scenario timing of cord clamping in term normal vaginal delivery was at least more than 30 seconds to 1 minute while in term babies born via cesarean section was 15 to 30 seconds on an average. Limitations: For further evaluation of hematological status of healthy infants beyond 6 hours of life it is difficult to get consent of parents without any obvious cause to investigate. CONCLUSION: Delayed cord clamping at birth increases neonatal hematological status within a physiologic range. Neither significant differences nor harmful effects were observed among the two groups. Furthermore, this intervention seems to reduce neonatal anemia. This practice has been shown to be safe and should be implemented to increase the hematological status of Indian newborn babies.