TY - JOUR
T1 - Delayed Umbilical Cord Clamping at <32 Weeks' Gestation
T2 - Implementation and Outcomes
AU - Rhoades, Janine S.
AU - Bierut, Tatiana
AU - Conner, Shayna N.
AU - Tuuli, Methodius G.
AU - Vesoulis, Zachary A.
AU - Macones, George A.
AU - Cahill, Alison G.
N1 - Publisher Copyright:
© 2017 by Thieme Medical Publishers, Inc.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Objectives This study aims to evaluate the implementation of a delayed umbilical cord clamping (DCC) protocol for neonates <32 weeks. Secondarily, to evaluate the impact of DCC on maternal outcomes and on the ability to obtain umbilical cord blood gases. Study Design Retrospective cohort study from November 2014 to March 2016 of patients delivered by 31 6/7 weeks. In 2014, an institutional protocol for DCC at <32 weeks was implemented. We assessed adherence to the protocol and compared adverse maternal outcomes (utilizing a hemorrhage composite). We evaluated the impact of DCC on the ability to obtain adequate umbilical cord blood gas specimens. Results Of the 185 patients included in the study, 90 underwent DCC, and 72% of potentially eligible patients appropriately received DCC. There was no significant difference in the maternal hemorrhage composite outcome between DCC and immediate cord clamping (23.3 vs. 36.8%, adjusted odds ratio = 0.64, 95% confidence interval = 0.33, 1.26). There was also no significant difference in the ability to obtain a single or paired umbilical cord blood gas result. Conclusion Implementation of a DCC protocol for preterm neonates is feasible and was successful. We did not find an increase in maternal risk or a decrease in the ability to obtain umbilical cord blood gases following DCC.
AB - Objectives This study aims to evaluate the implementation of a delayed umbilical cord clamping (DCC) protocol for neonates <32 weeks. Secondarily, to evaluate the impact of DCC on maternal outcomes and on the ability to obtain umbilical cord blood gases. Study Design Retrospective cohort study from November 2014 to March 2016 of patients delivered by 31 6/7 weeks. In 2014, an institutional protocol for DCC at <32 weeks was implemented. We assessed adherence to the protocol and compared adverse maternal outcomes (utilizing a hemorrhage composite). We evaluated the impact of DCC on the ability to obtain adequate umbilical cord blood gas specimens. Results Of the 185 patients included in the study, 90 underwent DCC, and 72% of potentially eligible patients appropriately received DCC. There was no significant difference in the maternal hemorrhage composite outcome between DCC and immediate cord clamping (23.3 vs. 36.8%, adjusted odds ratio = 0.64, 95% confidence interval = 0.33, 1.26). There was also no significant difference in the ability to obtain a single or paired umbilical cord blood gas result. Conclusion Implementation of a DCC protocol for preterm neonates is feasible and was successful. We did not find an increase in maternal risk or a decrease in the ability to obtain umbilical cord blood gases following DCC.
KW - delayed cord clamping
KW - delayed umbilical cord clamping
KW - timing of cord clamping
KW - umbilical cord blood gas
KW - umbilical cord clamping
UR - http://www.scopus.com/inward/record.url?scp=85029907378&partnerID=8YFLogxK
U2 - 10.1055/s-0037-1603591
DO - 10.1055/s-0037-1603591
M3 - Article
C2 - 28561189
AN - SCOPUS:85029907378
SN - 0735-1631
VL - 34
SP - 1048
EP - 1053
JO - American journal of perinatology
JF - American journal of perinatology
IS - 11
ER -