title: Effects of early versus delayed umbilical cord clamping during antepartum lower segment caesarean section on placental delivery and postoperative haemorrhage: a randomised controlled trial
abstract: Although recommended, delayed cord
  clamping (DCC) is not frequently practised during lower
  segment caesarean section (LSCS).
  
  
  
  To assess the effects of DCC during antepartum
  LSCS on placental delivery and postoperative hemorrhage
  
  
  
  A randomised controlled trial was carried out on
  156 women undergoing antepartum LSCS between 37-39
  weeks gestation at the Academic Obstetric Unit, Teaching
  Hospital Mahamodara, Galle from 21st January to 30th April
  2013. One surgeon carried out the LSCS and the same
  operative technique was used on all. The umbilical cord of
  the baby was clamped at <15 seconds (n=52) or between
  60 - 75 seconds (n=52) or between 120 - 135 seconds
  (n=52) according to a predetermined randomised allocation
  sequence. Postoperative hemorrhage, time taken for
  delivery of placenta, requirement of manual removal of
  placenta and additional uterotonics, and reduction of
  maternal haemoglobin and haemotocrit 48 - 60 hours
  after LSCS, were measured. The neonate was monitored
  for 72 hours.
  
  
  
  There were no significant differences in postoperative
  haemorrhage or neonatal morbidity between
  the groups. There was a clinically non-significant increase
  in the time taken for placental delivery. The trend of
  reduction in the need for manual removal of placentae
  and additional uterotonics with DCC was not significant.
  The trend of increased requirement of phototherapy for
  neonatal jaundice with DCC was not significant.
  
  
  
  There were no significant differences in the
  risk of postoperative haemorrhage, manual removal of
  placenta, or maternal or neonatal morbidity between early
  cord clamping and DCC during antepartum LSCS.
authors.forename: M
authors.initials: M
authors.lastname: Withanathantrige
authors.affiliation: Academic Obstetrics and Gynaecology Unit, Teaching Hospital, Mahamodara, Galle, Sri Lanka. malikg@eureka.lk
authors.forename: I M
authors.initials: I
authors.lastname: Goonewardene