[Delayed cord clamping in the interest of the newborn child].
The importance of delayed cord clamping, both for the preterm and for the term newborn, for the prevention ofneonatal anaemia (during the neonatal period and/or at the age of3 months) and furthermore to reduce the need of blood transfusions, has recently been demonstrated in controlled clinical studies and meta-analyses. Physiological and pathophysiological factors also provide a rationale for delayed cord clamping: neonatal blood volume may increase by 32% if cord clamping is delayed until the umbilical cord has completely stopped pulsating. A slow transition, involving closure of the ductus arteriosus and the foramen ovale cordis and gradual filling of the neonatal systemic circulation, contributes to the opening of the alveoli due to perfusion of the alveolar capillaries. No disadvantages, such as polycythaemia or hyperbilirubinaemia, have been described with regard to preterm neonates, whereas the incidence of intracranial haemorrhages is reduced. Also for the mother, no disadvantages of late clamping have been determined. As a standard procedure, the baby's umbilical cord should not be clamped until at least 3 minutes have passed. One should wait at least 30 seconds during the birth of children for whom a more active approach is necessary. Of all people, these children will benefit from a good Hb level.
Scherjon
S A
SA
Leids Universitair Medisch Centrum, afd. Obstetrie, K6-26, Postbus 9600, 2300 RC Leiden. s.scherjon@lumc.nl
Smit
Y
Y
D003250:Constriction; D036861:Delivery, Obstetric / Q000379:methods*; D005312:Fetal Blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D007234:Infant, Premature / Q000097:blood*; D018743:Perinatal Care / Q000379:methods*; D011086:Polycythemia / Q000453:epidemiology; D012307:Risk Factors; D047929:Term Birth; D013997:Time Factors; D014470:Umbilical Cord / Q000601:surgery
D006454:Hemoglobins