Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial.
OBJECTIVE
To investigate the effect of delayed cord clamping (DCC) compared with early cord clamping (ECC) on maternal postpartum hemorrhage (PPH) and umbilical cord blood gas sampling.


METHODS
Secondary analysis of a parallel-group, single-center, randomized controlled trial.


METHODS
Swedish county hospital.


METHODS
382 term deliveries after a low-risk pregnancy.


METHODS
Deliveries were randomized to DCC (≥180 seconds, n = 193) or ECC (≤10 seconds, n = 189). Maternal blood loss was estimated by the midwife. Samples for blood gas analysis were taken from one umbilical artery and the umbilical vein, from the pulsating unclamped cord in the DCC group and from the double-clamped cord in the ECC group. Samples were classified as valid when the arterial-venous difference was -0.02 or less for pH and 0.5 kPa or more for pCO2 . Main outcome measures. PPH and proportion of valid blood gas samples.


RESULTS
The differences between the DCC and ECC groups with regard to PPH (1.2%, p = 0.8) and severe PPH (-2.7%, p = 0.3) were small and non-significant. The proportion of valid blood gas samples was similar between the DCC (67%, n = 130) and ECC (74%, n = 139) groups, with 6% (95% confidence interval: -4%-16%, p = 0.2) fewer valid samples after DCC.


CONCLUSIONS
Delayed cord clamping, compared with early, did not have a significant effect on maternal postpartum hemorrhage or on the proportion of valid blood gas samples. We conclude that delayed cord clamping is a feasible method from an obstetric perspective.
Department of Pediatrics, Hospital of Halland, Halmstad Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. ola.k.andersson@regionhalland.se
Ola
O
Andersson
Lena
L
Hellström-Westas
Dan
D
Andersson
Jesper
J
Clausen
Magnus
M
Domellöf
D001784:Blood Gas Analysis; D003250:Constriction; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D007231:Infant, Newborn; D006473:Postpartum Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014470:Umbilical Cord