Abstract
Deferred or delayed cord clamping (is currently recommended by several national and international organizations in preterm and term neonates not needing immediate resuscitation. [1] American College of O, Gynecologists' Committee on Obstetric PDelayed Umbilical Cord Clamping After Birth: ACOG Committee Opinion, Number 814. Obstetrics and gynecology. 2020; 136: e100-e106 Crossref PubMed Scopus (35) Google Scholar The benefits of DCC can be categorized as respiratory, hematologic and hemodynamic (figure 1). The benefits of gas exchange are evident from higher oxygen saturation (SpO2) during the first few minutes in infants delivered with DCC secondary to oxygenated umbilical venous return compared with early cord clamping (ECC, figure 1A). 2 Padilla-Sanchez C. Baixauli-Alacreu S. Canada-Martinez A.J. Solaz-Garcia A. Alemany-Anchel M.J. Vento M. Delayed vs Immediate Cord Clamping Changes Oxygen Saturation and Heart Rate Patterns in the First Minutes after Birth. The Journal of pediatrics. 2020; 227: 149-156 e1 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 3 Andersson O. Rana N. Ewald U. Malqvist M. Stripple G. Basnet O. et al. Intact cord resuscitation versus early cord clamping in the treatment of depressed newborn infants during the first 10 minutes of birth (Nepcord III) - a randomized clinical trial. Maternal health, neonatology and perinatology. 2019; 5: 15 Crossref PubMed Google Scholar , 4 Kc A. Singhal N. Gautam J. Rana N. Andersson O. Effect of early versus delayed cord clamping in neonate on heart rate, breathing and oxygen saturation during first 10 minutes of birth - randomized clinical trial. Maternal health, neonatology and perinatology. 2019; 5: 7 Crossref PubMed Google Scholar Physiologic-based cord clamping refers to DCC that is not exclusively time-based but based on physiology and clamping after lung aeration. PBCC is thought to provide hemodynamic benefits by establishing pulmonary venous return while umbilical venous return continues to be a source of left ventricular preload (figure 1B). 5 Hooper S.B. Polglase G.R. te Pas A.B. A physiological approach to the timing of umbilical cord clamping at birth. Archives of disease in childhood Fetal and neonatal edition. 2015; 100: F355-F360 Crossref PubMed Scopus (67) Google Scholar , 6 Hooper S.B. Binder-Heschl C. Polglase G.R. Gill A.W. Kluckow M. Wallace E.M. et al. The timing of umbilical cord clamping at birth: physiological considerations. Maternal health, neonatology and perinatology. 2016; 2: 4 Crossref PubMed Google Scholar , 7 Lakshminrusimha S. Van Meurs K. Better timing for cord clamping is after onset of lung aeration. Pediatric research. 2015; 77: 615-617 Crossref PubMed Scopus (8) Google Scholar
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