TY - JOUR
T1 - Implementation and Outcomes of Universal Delayed Umbilical Cord Clamping at Term
AU - Rhoades, Janine S.
AU - Wesevich, Victoria G.
AU - Tuuli, Methodius G.
AU - Macones, George A.
AU - Cahill, Alison G.
N1 - Publisher Copyright:
© 2019 by Thieme Medical Publishers, Inc.
PY - 2019
Y1 - 2019
N2 - Objective To evaluate the implementation of an institutional protocol for universal delayed umbilical cord clamping (DCC) at term on maternal, neonatal, and umbilical cord blood gas outcomes. Study Design This is a retrospective cohort study of singleton term gestations from April through July 2017. On June 1, 2017, a protocol was implemented for DCC in all deliveries. Outcomes were compared between patients delivered prior to and those delivered after implementation. The primary outcome was postpartum hemorrhage (PPH). Secondary outcomes were additional adverse maternal, neonatal, and umbilical cord blood gas outcomes. Multivariable logistic regression was used to adjust for potential confounders. Results Of 682 patients, 341 were delivered preprotocol and 341 were delivered postprotocol. After implementation, there was 91.8% adherence to the protocol. Overall, there was no significant difference in PPH between patients delivered preprotocol and those delivered postprotocol (8.2 vs. 13.2%; adjusted relative risk [aRR]: 1.26, 95% confidence interval [CI]: 0.98-1.51). There was a significant decrease in the ability to obtain paired arterial and venous umbilical cord blood gases from preprotocol to postprotocol (83 vs. 63.6%; aRR: 0.62 [95% CI: 0.50-0.76]). There were no significant differences in abnormal umbilical cord blood gases or neonatal outcomes. Conclusion We did not find an increased risk of adverse outcomes associated with the widespread use of DCC.
AB - Objective To evaluate the implementation of an institutional protocol for universal delayed umbilical cord clamping (DCC) at term on maternal, neonatal, and umbilical cord blood gas outcomes. Study Design This is a retrospective cohort study of singleton term gestations from April through July 2017. On June 1, 2017, a protocol was implemented for DCC in all deliveries. Outcomes were compared between patients delivered prior to and those delivered after implementation. The primary outcome was postpartum hemorrhage (PPH). Secondary outcomes were additional adverse maternal, neonatal, and umbilical cord blood gas outcomes. Multivariable logistic regression was used to adjust for potential confounders. Results Of 682 patients, 341 were delivered preprotocol and 341 were delivered postprotocol. After implementation, there was 91.8% adherence to the protocol. Overall, there was no significant difference in PPH between patients delivered preprotocol and those delivered postprotocol (8.2 vs. 13.2%; adjusted relative risk [aRR]: 1.26, 95% confidence interval [CI]: 0.98-1.51). There was a significant decrease in the ability to obtain paired arterial and venous umbilical cord blood gases from preprotocol to postprotocol (83 vs. 63.6%; aRR: 0.62 [95% CI: 0.50-0.76]). There were no significant differences in abnormal umbilical cord blood gases or neonatal outcomes. Conclusion We did not find an increased risk of adverse outcomes associated with the widespread use of DCC.
KW - delayed cord clamping
KW - delayed umbilical cord clamping
KW - placental transfusion
KW - postpartum hemorrhage
KW - umbilical cord blood gas
UR - http://www.scopus.com/inward/record.url?scp=85061476148&partnerID=8YFLogxK
U2 - 10.1055/s-0038-1669908
DO - 10.1055/s-0038-1669908
M3 - Article
C2 - 30208504
AN - SCOPUS:85061476148
SN - 0735-1631
VL - 36
SP - 233
EP - 242
JO - American journal of perinatology
JF - American journal of perinatology
IS - 3
ER -