Effects Of Umbilical Cord Clamping Research Articles

Impact of the Timing of Umbilical Cord Clamping on Maternal and Neonatal Outcomes in Saudi Arabia.

The optimal time for umbilical cord clamping after delivery has been under debate for several decades. This study aimed to assess the time-dependent effects of umbilical cord clamping on maternal and neonatal outcomes. An observational correlational design was used to recruit 161 pregnant women conveniently. Outcomes were observed and recorded using a structured checklist developed by the authors.Pregnant females aged ≥18 years, with uncomplicated delivery, and who were willing to participate were recruited. Exclusion criteria included stillbirths, newborns with congenital anomalies, newborns too small for their gestational age, intra-uterine growth restriction, nuchal cord, and meconium-stained liquor. The mean age of the participants was 29.93 ± 6 years. Early clamping (<1 minute) was performed for 93.8% of the participants with a mean of 29.58 ± 18 seconds. Delayed clamping was associated with a decrease in blood loss and the length of hospital stay in addition to an increase in first-minute APGAR score and neonatal temperature (P < 0.05). Delayed cord clamping was associated with improved maternal and neonatal outcomes.

Effects of Umbilical Cord Clamping on Early Brain Development in Term Infants in a Randomized Controlled Trial

To determine whether healthy, term infants who received delayed cord clamping (DCC) would have greater brain myelin volume and better neurodevelopmental outcomes compared with infants who received immediate cord clamping (ICC) at 12 months of age.

The Effect of Umbilical Cord Clamping, Cutting and Milking in Term Infants Delivered by Cesarean Section: A randomized controlled trial

Objectives: To investigate the effect of umbilical cord milking (UCM) and immediate umbilical cord clamping (ICC) in term infants delivered by cesarean section. Materials and Methods: This investigation’s design was a randomized controlled trial. One hundred and ten term pregnant women were recruited and allocated equally in the study and control groups. The study group (UCM) undertook umbilical cord milking toward the infant five times in 30 seconds after the umbilical cord was immediately clamped at a 20 cm, length from the newborn. The control group (ICC), by contrast, underwent immediate umbilical cord clamping without milking at 2 cm from umbilicus as the standard manner. Neonatal outcomes such as neonatal hematocrit (Hct) at 48 hours after birth, microbilirubin level, respiratory rate and length of stay in hospital were recorded. Results: Neither neonatal outcomes nor neonatal Hct at 48 hrs revealed statistical differences between the two groups. There were no serious maternal and fetal complications in either group. The two groups showed no significant differences in demographic and operative data. Conclusion: UCM at a point 20 cm from umbilicus had no effect in raising the Hct level at 48 hours following birth and no harmful effect in the term newborn delivered by cesarean section.

Transition from fetal to neonatal circulation: Modeling the effect of umbilical cord clamping

Hemodynamics of the fetal to neonatal transition are orchestrated through complex physiological changes and results in cardiovascular adaptation to the adult biventricular circulation. Clinical practice during this critical period can influence vital organ physiology for normal newborns, premature babies and congenital heart defect patients. Particularly, the timing of the cord clamping procedure, immediate (ICC) vs. delayed cord clamping (DCC), is hypothesized to be an important factor for the transitory fetal hemodynamics. The clinical need for a quantitative understanding of this physiology motivated the development of a lumped parameter model (LPM) of the fetal cardio-respiratory system covering the late-gestation to neonatal period. The LPM was validated with in vivo clinical data and then used to predict the effects of cord clamping procedures on hemodynamics and vital gases. Clinical time-dependent resistance functions to simulate the vascular changes were introduced. For DCC, placental transfusion (31.3ml) increased neonatal blood volume by 11.7%. This increased blood volume is reflected in an increase in preload pressures by ~20% compared to ICC, which in turn increased the cardiac output (CO) by 20% (COICC=993ml/min; CODCC=1197ml/min). Our model accurately predicted dynamic flow patterns in vivo. DCC was shown to maintain oxygenation if the onset of pulmonary respiration was delayed or impaired. On the other hand, a significant 25% decrease in oxygen saturations was observed when applying ICC under the same physiological conditions. We conclude that DCC has a significant impact on newborn hemodynamics, mainly because of the improved blood volume and the sustained placental respiration.

Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs

Delayed cord clamping improves circulatory stability in preterm infants at birth, but the underlying physiology is unclear. We investigated the effects of umbilical cord clamping, before and after ventilation onset, on cardiovascular function at birth. Prenatal surgery was performed on lambs (123 days) to implant catheters into the pulmonary and carotid arteries and probes to measure pulmonary (PBF), carotid (CaBF) and ductus arteriosus blood flows. Lambs were delivered at 126 ± 1 days and: (1) the umbilical cord was clamped at delivery and ventilation was delayed for about 2 min (Clamp 1st; n = 6), and (2) umbilical cord clamping was delayed for 3-4 min, until after ventilation was established (Vent 1st; n = 6). All lambs were subsequently ventilated for 30 min. In Clamp 1st lambs, cord clamping rapidly (within four heartbeats), but transiently, increased pulmonary and carotid arterial pressures (by ∼30%) and CaBF (from 30.2 ± 5.6 to 40.1 ± 4.6 ml min(-1) kg(-1)), which then decreased again within 30-60 s. Following ventilation onset, these parameters rapidly increased again. In Clamp 1st lambs, cord clamping reduced heart rate (by ∼40%) and right ventricular output (RVO; from 114.6 ± 14.4 to 38.8 ± 9.7 ml min(-1) kg(-1)), which were restored by ventilation. In Vent 1st lambs, cord clamping reduced RVO from 153.5 ± 3.8 to 119.2 ± 10.6 ml min(-1) kg(-1), did not affect heart rates and resulted in stable blood flows and pressures during transition. Delaying cord clamping for 3-4 min until after ventilation is established improves cardiovascular function by increasing pulmonary blood flow before the cord is clamped. As a result, cardiac output remains stable, leading to a smoother cardiovascular transition throughout the early newborn period.

The alleviation by calcium channel antagonism of the effects of umbilical cord clamping in the rat

The alleviation by calcium channel antagonism of the effects of umbilical cord clamping in the rat