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Andrew B. Kairalla MD, Editor
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More on Delayed Cord Clamping
Baenziger O, Stolkin F, Keel M, et al. The Influence of the Timing of Cord Clamping on Postnatal Cerebral Oxygenation in Preterm Neonates: A Randomized, Controlled Trial. PEDIATRICS (March 2007); 119: 455-459. [Full text] [PDF]
OBJECTIVE. Our goal was to investigate the effect of placentofetal transfusion on cerebral oxygenation in preterm infants by near-infrared spectroscopy.
SUBJECTS. A total of 39 preterm infants with a median gestational age of 30.4 weeks were randomly assigned to an experiment group (n = 15) and a control group (n = 24).
INTERVENTIONS. The delivery of the infants in the experiment group was immediately followed by maternal administration of syntocinon, the infant was placed 15 cm below the placenta, and cord clamping was delayed by 60 to 90 seconds. The infants in the control group were delivered conventionally. At the ages of 4 and 24 hours, cerebral hemoglobin concentrations, cerebral blood volume, and regional tissue oxygenation were measured by near-infrared spectroscopy.
RESULTS. Cerebral blood volume was not different between the 2 groups at the age of 4 hours (6.1 vs. 5.8 mL/100 g of tissue) nor at the age of 24 hours (6.2 vs. 6.2 mL/100 g of tissue). Mean regional tissue oxygenation of the experiment group was higher at the ages of 4 hours (69.9% vs. 65.5%) and of 24 hours (71.3% vs. 68.1%).
CONCLUSION. Delayed clamping of the umbilical cord improves cerebral oxygenation in preterm infants in the first 24 hours.
Comments: We now have yet another strong reason that delayed
cord clamping is beneficial for premature babies – improved cerebral
oxygenation. Other proven or reported benefits to this simple procedure
include fewer blood transfusions and less need for blood pressure support (See
1-024 and
3-019), less hypoglycemia, less severe CLD, and less suspected NEC (see
4-038), less IVH and less late-onset sepsis (see
7-013). Why are continuing to ignore the data that supports the many
benefits of placentofetal transfusion in preterm babies. As I said before, It
is time for neonatologists to remind their obstetric colleagues to “Wait a
Minute” before reaching for the cord clamp, especially in preterm deliveries.
ABK.
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