A comparative study of early and delayed cord clamping in term deliveries

Abstract

Background: Timing of clamping of the umbilical cord has always been a debatable issue. Early cord clamping (ECC) is defined as clamping of the cord within 30 seconds of delivery of the baby and delayed cord clamping (DCC) is defined as clamping of the cord between 30 to 120 seconds of delivery. Delayed cord clamping, despite some limitations, is said to be beneficial to the neonate. A comparative study between ECC and DCC was carried out on a select group of term pregnant women without any high-risk factor and delivering at term. Aim of the study was to compare the effects of early versus delayed cord clamping on neonates and mothers. The focus was on the neonatal haemoglobin levels and adverse effects, if any on neonates and mothers in the two groups.Methods: 100 women satisfying the inclusion/exclusion criteria were recruited for the study. They were randomly divided into two groups of 50 each. Group A underwent early cord clamping and Group B delayed cord clamping. Mothers were observed for 1 hour post-delivery for any evidence of post-partum haemorrhage. Neonates were observed for any sign of tachypnea and blood sample was sent after 72 hours of delivery for analyzing Hb, hematocrit and bilirubin of the neonate.Results: The results revealed that neonates with DCC had a higher mean Hb level of 15.02 vis-à-vis the ECC group Hb of 11.69G/dl and the difference was statistically significant. Similarly mean hematocrit of DCC group was 48.67 while the ECC group mean was 42.36, the difference again was statistically significant. There was no significant side effects or complications in both mother and newborn babies.Conclusions: It was concluded that delayed cord clamping should be practiced in otherwise non high-risk deliveries.

The Effect of Different Timings of Delayed Cord Clamping of Term Infants on Maternal and Newborn Outcomes in Normal Vaginal Deliveries

“…Compared with early cord clamping (ECC), DCC can effectively increase hemoglobin and serum ferritin levels and prevent anemia among newborns [5,[10][11][12][13][14]. The present study confirmed the benefit of DCC among newborns, as evidenced by the significantly increased hemoglobin levels at 24-48 hours of age with DCC at three minutes compared to that with DCC at one or two minutes.…”

“…However, DCC is associated with a few potential complications, including hyperbilirubinemia and polycythemia. In many trials, more hyperbilirubinemia cases were identified following DCC than ECC [ 8 , 13 , 17 , 18 ]. Consistently, in the present study, bilirubin levels in the DCC at three minutes group were higher than those in the DCC at one and two minutes groups.…”

Increment in Phototherapy After Adopting Delayed Cord Clamping Practice

“…The mean total bilirubin level of infants in group with ECC was 2.06 mg/dL and in DCC group it was 4.92 mg/dL ( P value: .003). 14 Same study also found that the mean hematocrit level was significantly higher in the DCC group with the mean of 48.67 (range: 32-71%) in comparison to the ECC group with the mean of 42.36 (range: 30-70%) with P value of .002. In our study, we have found that the increment in phototherapy is increased by 47% in DCC group as compared to ECC group.…”