Circulating RBC volume, measured with biotinylated RBCs, is superior to the Hct to document the hematologic effects of delayed versus immediate umbilical cord clamping in preterm neonates

Strauss, Ronald G.; Mock, Donald M.; Johnson, Karen; Mock, Nell I.; Cress, Gretchen A.; Knosp, Laura; Lobas, Lori; Schmidt, Robert L.

doi:10.1046/j.1537-2995.2003.00454.x

Cited by 75 publications

(63 citation statements)

References 9 publications

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“…Regarding the consequence of a rapid change in the hematocrit level that normally occurs during the first 24 hours of life, comparing late with early cord clamping, the risk of anemia was decreased with late cord clamping at 24 to 48 hours after birth [24,25]. Van Rheenen [23,26] showed that the most important finding was that the beneficial effects of late cord clamping appear to extend beyond the early neonatal period and it is a physiological and inexpensive means of enhancing hematologic status, preventing anemia over the first 3 months of life and enriching iron stores and ferritin levels for as long as 6 months.…”

Section: Figurementioning

confidence: 99%

“…Based on the above Figure Strauss [24] stressed that delaying clamping of the umbilical cord for at least 2 minutes after birth consistently improved feto placental circulation and both the short-and long-term hematologic and iron status of full term infants.…”

Section: Figurementioning

confidence: 99%

“…Delayed clamping is compatible with active management of the third stage of labor and have been shown to increase the rate of placental transfusion and are thus likely to enhance the effect of delayed clamping [29,30].…”

Section: Maternal Outcomesmentioning

confidence: 99%

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Effect of Early and Late Clamping of the Umbilical Cord on the Newborns Blood Analysis

Ninia¹,

Ashmauey²,

Qahtani³

2017

J Nurs Health Stud

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Background: At the time of birth, the infant is still attached to the mother via the umbilical cord, which is a part of the placenta. The infant is usually separated from the placenta by clamping the cord. Timing of umbilical cord clamping has been and still is a highly controversial issue worldwide, the controversy about the best time to clamp the cord. The main aim of the study is to identify the effect of early and late cord clamping on newborns' blood analysis.

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Section: Figurementioning

confidence: 99%

Section: Figurementioning

confidence: 99%

See 1 more Smart Citation

Effect of Early and Late Clamping of the Umbilical Cord on the Newborns Blood Analysis

Ninia¹,

Ashmauey²,

Qahtani³

2017

J Nurs Health Stud

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“…29 Preterm infants (30-36 weeks' gestation at birth) randomized to delayed cord clamping (at 1 minute of age) had larger circulating red blood cell (RBC) volume, no difference in hematocrit at birth, but higher hematocrit at 7, 14, 21, and 28 days of age compared with preterm infants randomized to immediate cord clamping within 5 seconds of birth. 30,31 There was no increase in polycythemia or jaundice in the delayed cord clamping groups. 31 Another randomized controlled trial found that preterm infants assigned to delayed cord clamping (30-90 seconds after birth) had significantly higher blood volumes regardless of mode of delivery (cesarean section or vaginal delivery) compared with infants who had immediate cord clamping.…”

Section: Preterm Infantsmentioning

confidence: 80%

Untitled

2017

Amer J Perinatol

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Management of the third stage of labor includes clamping of the umbilical cord after delivery of the infant, use of uterotonic medications (e.g., Pitocin) and controlled traction applied to the umbilical cord, and possibly uterine massage. This review will focus on the first step in the process, that is, cord clamping.It is often useful to be familiar with the historical practice of medicine as it can influence decisions and evaluation of our current practice. Dr. A.C. Beck wrote in 1941, "Often the cord is clamped at once…this practice is reprehensible since it deprives the immature infant of considerable blood, which it otherwise might take up from the placental circulation… Blood in the umbilical cord should be stripped toward the fetus before the umbilical cord is ligated." 1 The practice of immediate cord clamping after delivery of the newborn infant has recently been challenged by the American College of Obstetrics and Gynecology. The Committee on obstetric practice stated that the evidence now supports the routine delay in cord clamping for at least 30 to 60 seconds for all vigorous term and preterm neonates. 2 In addition, the seventh edition of the Textbook on Neonatal Resuscitation now recommends this practice. 3The purpose of this review is to present the evidence in support of delayed clamping of the umbilical cord. First, we will discuss the effects of delayed cord clamping or cord milking on the transitional physiology of neonates. Then, we will review the effects of delayed cord clamping on neonatal outcomes. Delayed Cord Clamping and Transitional PhysiologyOne needs to understand the physiology of cardiovascular and respiratory transition as a foundation for understanding the role of placental transfusion that results from delayed cord clamping. There are several aspects of transitional physiology to be considered including effects of lung expansion, changes in the distribution of cardiac output, and blood volume shifts that could benefit from placental transfusion and the possible benefits of the transfusion of stem cells into the newborn.The fetal circulation allows for only 7 to 8% of cardiac output into the lungs. 4,5 Over 90% of cardiac output supplies the systemic circulation, of which 35% comes from left ventricular output and the remainder through the fetal shunt supplied by the patent ductus arteriosus (PDA) 6 as shown AbstractThis review presents the effects of delayed umbilical cord clamping on neonatal transitional physiology. The effects of delayed cord clamping on short-and long-term neonatal outcomes are then discussed. There is ample evidence over the last 50 years that delayed cord clamping in preterm infants is beneficial for both short-term and long-term outcomes. Providing ventilation in the initial steps of neonatal resuscitation prior to clamping of the umbilical cord has a physiologic basis and results in better outcomes for newborns. The challenge now is to design equipment and strategies that can allow initial resuscitation very close to the mother while the umbilical cor...

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“…Nevertheless, the use of radioactive substances for research in infants would be considered ethically unacceptable in the 21st century. Fortunately, biotin has been developed as a safe, nonradioactive RBC label for studies of RCV and RBC survival in infants (10,11,14,24,25), allowing continued research in this important area.…”

Section: Red Cell Volume Changes In Vlbw Infantsmentioning

confidence: 99%

Changes in circulating red cell volume during the first 6 weeks of life in very-low-birth-weight infants

et al. 2013

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ArticlesClinical Investigation nature publishing group background: Little is known about the change in circulating red cell volume (RCV) of very-low-birth-weight (VLBW) infants during the first weeks of life. Methods: RCV was measured during the first 5 d in 35 VLBW infants using chromium-51 labeling of the infants' red blood cells (RBCs). RCV was measured again at 6 wk of age in 12 infants, and the volumes of RBCs lost by phlebotomy and those gained by transfusion were recorded between the RCV measurements. In six infants, the volume of waste blood on materials contaminated with blood during phlebotomy, which would usually be discarded, was measured by radioactive counting. results: The mean RCV in the first several days of life was 39.6 ml (35.7 ml/kg; range: 20.1-58.7 ml/kg). Of the 12 infants whose RCV was measured twice, all but one had a decrease in absolute RCV. The mean RCV initially and at 6 wk were 37.3 and 26.6 ml, respectively. The mean volume of RBCs lost through phlebotomy was 29.2 ml, and the mean volume of RBCs given by transfusion was 34.5 ml. conclusion: During the first 6 wk of life, when the anemia of prematurity is evolving, the RCV falls despite complete replacement of RBCs lost by diagnostic phlebotomy with transfused RBCs.

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Circulating RBC volume, measured with biotinylated RBCs, is superior to the Hct to document the hematologic effects of delayed versus immediate umbilical cord clamping in preterm neonates

Cited by 75 publications

References 9 publications

Effect of Early and Late Clamping of the Umbilical Cord on the Newborns Blood Analysis

Effect of Early and Late Clamping of the Umbilical Cord on the Newborns Blood Analysis

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Changes in circulating red cell volume during the first 6 weeks of life in very-low-birth-weight infants

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