Abstract
Background: Physiologic-based cord clamping (PBCC) involves deferring umbilical cord clamping until after lung aeration. It is unclear if infant is at risk of becoming hypothermic during PBCC.Objectives: To test if PBCC would maintain core temperature more effectively than immediate cord clamping (ICC).Design: At 0.93 gestation, fetal lambs were surgically exteriorized and instrumented from pregnant ewes under general anesthesia. Prior to the start of the experiment, lambs were thoroughly dried, placed on hot water bottles, and core temperature was continuously monitored using a rectal thermometer. PBCC lambs (n = 21), received intermittent positive pressure ventilation (iPPV) for ≥5 min prior to umbilical cord clamping. In ICC lambs (n = 23), iPPV commenced within 60 s after umbilical cord clamping. iPPV was provided with heated/humidified gas. Lambs were moved under a radiant warmer after umbilical cord clamping. Additional warmth was provided using a plastic overlay, hairdryer, and extra water bottles, as needed. Two-way mixed and repeated measures one-way ANOVAs were used to compare temperature changes between and within a single group, respectively, over time.Results: Basal fetal parameters including core temperature were similar between groups. ICC lambs had a significant reduction in temperature compared to PBCC lambs (p < 0.001), evident by 1 min (p = 0.002). ICC lambs decreased temperature by 0.51°C (± 0.42) and 0.79°C (± 0.55) at 5 and 10 min respectively (p < 0.001). In PBCC lambs, temperature did not significantly change before or after umbilical cord clamping (p = 0.4 and p = 0.3, respectively).Conclusions: PBCC stabilized core temperature at delivery better than ICC in term lambs. Hypothermia may not be a significant risk during PBCC.
Highlights
- Physiologic-based cord clamping is deferring umbilical cord clamping until the non-vigorous newborn has commenced breathing or respiratory support has started and the lung has aerated
- Physiological-based cord clamping maintained core temperature stability compared to immediate cord clamping in near-term, newborn lambs
- Immediate cord clamping resulted in a significant decrease in core temperature in anesthetized, near-term lambs, despite extensive efforts to maintain euthermia in all subjects
Summary
Physiologic-based cord clamping (PBCC) involves deferring umbilical cord clamping until after the newborn has commenced breathing or respiratory support has started and the lung has aerated. It is not clear whether infants are at increased risk of hypothermia during PBCC, since umbilical cord clamping may be deferred for several minutes, delaying the time between birth and when the infant receives heat from the radiant warmer [1,2,3,4]. Randomized trials comparing deferred umbilical cord clamping to immediate cord clamping (ICC) have not shown increased risk of hypothermia [18,19,20,21] It is unclear if infant is at risk of becoming hypothermic during PBCC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
