A Quasi-Experimental Study to Assess Consequences of Early Versus Delay Umbilical Cord Clamping on Maternal and Neonatal Outcomes in Beni-Suef city (original) (raw)
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Effects of Deferred Versus Early Umbilical Cord Clamping on Maternal and Neonatal Outcomes
Background: Recent protocol proposed by the World Health Organization to manage the third stage of labour replaced the early cord clamping by deferred cord clamping to induce numerous neonatal benefits. But this practice is still resisted in most of the Arab countries. The aim of this study was to evaluate the effectiveness of deferred versus early umbilical cord clamping on maternal and neonatal outcomes. Methods: A quasi experimental research design was utilized. The study was conducted at labour unit in Damanhour National Medical Institute. Sample: A convenience sample of 150 parturient women undergoing normal vaginal delivery were randomly divided in two groups; deferred cord clamping (n= 75) and early cord clamping (n= 75). Tools: Three tools were used for data collection; 1) Structured interview schedule to collect data about the women' demographic characteristics and reproductive history. 2) Maternal outcomes assessment sheet. 3) Neonatal outcomes assessment sheet to assess the immediate and late neonatal outcomes. Results: There were no statistically significant differences (P > 0.05) between deferred and early cord clamping groups in relation to the maternal risk for post-partum hemorrhage, duration of third stage of labour and the need for manual removal of the placenta. Furthermore, a highly statistically significant differences (p < 0.001) were observed regarding neonatal hemoglobin, hematocrit, and red blood cells between the two groups. The mean total bilirubin level was significantly higher (P < 0.05) in the deferred cord clamping group than early cord clamping group. Conclusion: The study concluded that deferred umbilical cord clamping did not increase the risk of maternal post-partum hemorrhage, duration of third stage of labour or the need for manual removal of the placenta. Also, deferred cord clamping significantly increased neonatal hemoglobin, hematocrit, and red blood cells level without serious elevation in the total bilirubin level as it was still in the low intermediate risk or below 75 th percentile. Recommendation: Institutionalization of deferred cord clamping in all governmental hospitals and medical educational settings through providing policies, procedures and guidelines regarding this practice. This could significantly improve the intra-natal care for the neonate without harmful consequences for the mother. Cite This Article: Wafaa Taha Ibrahim Elgzar, Heba Abdel-Fatah Ibrahim, and Hanan Heiba Elkhateeb, " Effects of Deferred Versus Early Umbilical Cord Clamping on Maternal and Neonatal Outcomes.
Effect of Delayed Cord Clamp on Maternal and Neonatal Outcomes
The Malaysian journal of nursing, 2022
Background: Third-stage labor with a Delayed Cord Clamp (DCC), is still being discussed and there are currently no definite regulations or instructions for doctors to abide by, and little knowledge exists on the possible consequences for both the mother and the baby. Aim: Evaluate the effect of delayed cord clamp on maternal and neonatal outcomes. Methods: The posttest-only quasi-experimental research design was carried out. This study was conducted at the labor and delivery unit at Mansoura University Hospital (MUH). A convenient sample of 200 laboring mothers. The first 100 mothers were the study group. The second 100 mothers were the control group. Four tools were utilized to gather data. structured interview questionnaire the maternal assessment, the maternal satisfaction questionnaire and the neonatal assessment tool. Results: More than three-quarters of the study group compared to less than two-thirds of the control group had a duration third stage of labor within 5-10 minutes with a highly statistically significant difference at (p=0.001). Three cases of postpartum hemorrhage occur in the DCC group as compared to 5% in the control group. There was a noticeable contrast in the health of newborn babies between the two groups after 24 hours, particularly in regard to hemoglobin, hematocrit, ferritin, and total bilirubin levels. Conclusion: Delayed cord clamp is a safe and simple procedure during the third stage of labour and is associated with better maternal and neonatal outcomes with no adverse effects. Recommendations: DCC should be performed routinely on all laboring mothers throughout the third stage of labor in all delivery units.
Impact of the Timing of Umbilical Cord Clamping on Maternal and Neonatal Outcomes in Saudi Arabia
Curēus, 2024
Introduction: The optimal time for umbilical cord clamping after delivery has been under debate for several decades. This study aimed to assess the time-dependent effects of umbilical cord clamping on maternal and neonatal outcomes. Methods: An observational correlational design was used to recruit 161 pregnant women conveniently. Outcomes were observed and recorded using a structured checklist developed by the authors. Pregnant females aged ≥18 years, with uncomplicated delivery, and who were willing to participate were recruited. Exclusion criteria included stillbirths, newborns with congenital anomalies, newborns too small for their gestational age, intra-uterine growth restriction, nuchal cord, and meconium-stained liquor. Results: The mean age of the participants was 29.93 ± 6 years. Early clamping (<1 minute) was performed for 93.8% of the participants with a mean of 29.58 ± 18 seconds. Delayed clamping was associated with a decrease in blood loss and the length of hospital stay in addition to an increase in first-minute APGAR score and neonatal temperature (P < 0.05). Conclusions: Delayed cord clamping was associated with improved maternal and neonatal outcomes.
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
Objective: To compare the effects of early versus delayed cord clamping of term births on maternal and neonatal outcomes. Method: A quasi-experimental study was conducted at the Jordan University Hospital in Amman. One hundred twenty-eight mothers expecting a full-term singleton baby were assigned to delayed cord clamping (90 seconds) or early cord clamping (<30 seconds). Results: Delayed cord clamping was associated with higher hemoglobin levels among newborns after 12 hours. On the other hand, early cord clamping was associated with an increased need for oxygen therapy among newborns and occurrence of postpartum hemorrhage among mothers. There were no differences between the groups on any other variable (Apgar score at 1 and 5 minutes, admission to NICU, baby bilirubin levels after 12 hours and day 3 of birth, and mothers' Hb levels after 12 hours of childbirth). Conclusion: Term babies receiving delayed cord clamping had improved hemoglobin levels with no adverse effect on other maternal and neonatal variables. Creating evidence-based practice guidelines for umbilical cord clamping in Jordanian hospitals is essential to improve neonatal and maternal health.
Early versus delayed cord clamping of term births in Shatby Maternity University Hospital
Abstract Back ground: The optimal timing for cord clamping; early versus delayed in the third stage of labour, is a controversial subject . There are no formed practice guidelines. Objective: To compare the potential benefits and harms of early versus late clamping in term infants in Shatby Maternity Hospital. Methods : A randomized study was conducted on 100 primigravide full term single pregnancy admitted and delivered spontaneously at Shatby Maternity University Hospital . They were divided into two groups (each 50) where in the first group the umbilical cord was clamped immediately “early cord clamping ” (ECC) and where the 2nd group the umbilical cord was clamped after pulsation had been ceased” delayed cord clamping” (DCC) and then Apgar score, Hemoglobin level , random blood sugar, oxygen saturation and bilirubin after 72 hours of labour of newborn were compared and analyzed . Results: There was no statistical significant difference between both groups as regards Apgar score , haemoglobin , Random blood sugar and bilirubin while , there was a statistical significant difference as regard O2 saturation . Conclusion: Delayed cord clamping is likely to result in better neonatal outcome. Key words: Early cord clamping (ECC), Delayed cord clamping (DCC), umbilical cord (UC).
Optimal timing of the clamping and cutting of the umbilical cord is yet to be clearly established, however evidence favours delayed umbilical cord clamping as it is beneficial with potential minimal or no risk to the mother and the baby. The evaluation of this cost effective, easy and practicable procedure especially in our settings where it is highly needed has not been done. Objective of the study is to assess maternal and neonatal outcomes of delayed versus early umbilical cord clamping in Irrua specialist teaching hospital. A prospective, three-armed, single Centre randomized controlled (open label) trials.234 participants were randomized into A, B and C arms, representing ECC within 30 seconds of birth, DCC at 2 minutes and three minutes for A, B and C arms respectively. Data was analyzed with the statistical package for social sciences (SPSS) version 20.0 IBM. Statistical comparison was done using Fisher's exact test for three groups and Student's t-test for two groups that are continuous variables while Chi-Square test was used for categorical variables. The level of significance was accepted when P-value is equal to or less than 0.05 and confident interval of 95%. Primary outcomes were maternal bloodloss post-partum and neonatal PCV, serum ferritin, transcutaneous bilirubin estimation/ serum bilirubin at 48 hours after birth and the infant's packed cell volume and serum ferritinat 492 Jombo et. al., Effects of Delayed Umbilical Cord Clamping On Maternal and Neonatal Outcomes in IRRUA: A Randomized Controlled (Open Label) Trial six weeks post-delivery. Secondary outcomes were maternal PPH and neonatal anaemia, jaundice, SBCU admission, phototherapy and EBT. In addition placenta weight and umbilical cord length were compared across groups with maternal satisfaction. 234 mothers-babies pairs were randomized into three groups A, B and C with 6.8% drop out rate, hence 218 mothers-babies pairs were analyzed out of which;75(34.4 %) for group A, 72 (33.0%) for group B and 71(32.6%) for group C. Thebaby's mean PCV and serum ferritins were higher in the DCC than ECC at 48 hours(F=61.0, P= <0.001 and F= 150.0, P= <0.001 respectively) which remained higher in DCC groups as compared to ECC group, at six weeks follow up after delivery (F=7.1, P= 0.001 and F= 379.1, P= <0.001 respectively). All the babies in group A (ECC) had anaemia which was 36 % or less in DCC groups. There was no significant difference between the three groups in respect to maternal blood loss, hyperbilirubinaemia, SCBU admission, and need for phototherapy. Delayed umbilical cord clamping for two minutes is better than ECC and is equally effective as DCC for three minutes. A follow up of cases with hyperbilirubinaemia showed a strong association to ABO incompatibility especially among group O Rh D positive mothers (X2 = 11.7, P = 0.011). It has been concluded that Delayed umbilical cord clamping is beneficial rather than harmful as it ensures higher packed cell volume and serum ferritin to the newborn even up to six weeks after birth at no maternal or neonatal risk. Two minutes of delay in umbilical cord clamping after birth is strongly recommended as an ideal optimal time for cord clamping in our rural setting.
Effect of Early versus Delayed Cord Clamping on Neonatal Outcome in Term Pregnancy
International Journal of Scientific and Research Publications (IJSRP), 2021
Introduction: Clamping and cutting of the umbilical cord during birth is by far the oldest and most common interventions in human.The objective of the study was to compare the effect of early versus delayed cord clamping on neonatal outcome in term pregnancy. Methodology: Hospital based prospective comparative interventional study was conducted in Paropakar Maternity and Women's Hospital, Nepal from August 2014 to January 2015. The study included 100 women having normal vaginal delivery and was divided in to early cord clamping (ECC) and delayed cord clamping (DCC) group. The venous blood of the baby was taken for determining neonatal outcome in emergency laboratory of the hospital. Data analysis was done with the help of computer using SPSS program-16 and the results were depicted as tables, diagrams or charts. For statistical test unpaired student t-test and levene's test were used. Result: The mean Hb level of the neonate 24 hours after the birth was 17.30g/dl in ECC and ...
Umbilical Cord Clamping: How Timing Affects Infant Health Outcomes
2021
The timing of umbilical cord clamping is commonly seen as an innocuous act. Many providers simply cut the cord as soon as they see fit without consideration as to what the impacts of this may be. Early umbilical cord clamping was initially considered a preventative measure for postpartum hemorrhage, but this myth has since been debunked. Now, the practice is still commonly implemented, but for reasons unknown. Delaying the clamping of the umbilical cord is thought to not only provide no risk to the mother but provide benefit to the newborn in relation to their fetal to adult physiologic transition. While this technique may not be beneficial to all neonates, putting it into practice in those who would benefit and implementing it into standard hospital and clinic protocol could prove to have benefit in neonatal health outcomes
Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal
BMC research notes, 2018
Delayed umbilical cord clamping (DCC) (≥ 60 s) is recognized to improve iron status and neurodevelopment compared to early umbilical cord clamping. The aim of this study is to identify current umbilical cord clamping practice and factors determining the timing of clamping in a low-resource setting where prevalence of anemia in infants is high. A cross-sectional study design including 128 observations of clinical practice in a tertiary-level maternity hospital in Kathmandu, Nepal. Overall 48% of infants received DCC. The mean and median cord clamping times were 61 ± 33 and 57 (38-79) s, respectively. Univariate analysis showed that infants born during the night shift were five times more likely to receive DCC (OR 5.6, 95% CI 1.4-38.0). Additionally, infants born after an obstetric complication were 2.5 times more likely to receive DCC (OR 2.5, 95% CI 1.2-5.3), and babies requiring ventilation had a 65% lower likelihood of receiving DCC (OR 0.35, 95% CI 0.13-0.88). Despite the existen...
Factors associated with umbilical cord clamping in term newborns
Revista da Escola de Enfermagem da USP, 2022
OBJECTIVE: To identify factors associated with umbilical cord clamping in term newborns and to compare the recording of clamping time in the medical record with what was observed. METHOD: Cross-sectional study, with 300 mothers-infants, in a university hospital. Clamping time and medical records were observed, and a structured questionnaire was applied to postpartum women for sociodemographic variables. Bivariate analysis, multivariate Poisson Regression model, and Kappa concordance test were performed. RESULTS: The percentage of late/optimal clamping observed was 53.7%. The associated factors were skin-to-skin contact in the delivery room (PR = 0.76; 0.61–0.95; p = 0.014), position of the newborn below the vaginal canal (PR = 2.6; CI95%: 1.66–4.07; p < 0.001), position of the newborn at the vaginal level (PR = 2.03; CI95%: 1.5–2.75; p < 0.001), and need for newborn resuscitation in the delivery room (PR = 1.42; CI95%; 1.16–1.73; p = 0.001). Kappa concordance level of the prof...