Current umbilical cord clamping practices and attitudes of obstetricians and midwives toward delayed cord clamping in Saudi Arabia

Abstract

BACKGROUNDIn Saudi Arabia, as in many countries, there is usually no clear definition of the timing of umbilical cord clamping (UCC) in the policies and procedures used by hospitals. The World Health Organization (WHO) recommends delayed cord clamping (DCC) (>1 minute after birth) as it can significantly improve hemodynamics and long-term neurodevelopment.OBJECTIVETo investigate current practices of healthcare professionals on the timing of UCC in Saudi Arabia.DESIGNCross-sectional survey.SETTINGFive tertiary hospitals in Riyadh, Saudi Arabia, during May to October 2016.SUBJECTS AND METHODSObstetricians and midwives completed a widely-used questionnaire on UCC practices.MAIN OUTCOME MEASURECurrent UCC practices and attitudes of obstetricians and midwives toward DCC.RESULTSEighty-two obstetricians and 75 midwives completed the questionnaire for a response rate of 80%. The majority of respondents were aged 30 years or older (81%) and 84% were females. Most respondents were non-Saudi (66%) and had an educational level of bachelor’s degree or higher (72%). Only 42% of respondents reported the existence of UCC guidelines in their practice; 38% reported the existence of a set time for UCC when the neonate was term and healthy, and only 32% had a set time for UCC in preterm neonates. While lower levels of agreement were reported among obstetricians and midwives on the benefits of DCC for babies requiring positive pressure ventilation, the majority of respondents (69–71%) thought that DCC was generally good for both term and preterm babies and that its benefits extend beyond the neonatal period.CONCLUSIONSWhile the majority of obstetricians and midwives that participated in this study had a positive perception toward DCC, this did not translate to their daily practice as most of these professionals reported a lack of existing UCC guidelines in their institutions. Further studies are warranted to confirm these findings.LIMITATIONSParticipant selection by convenience sampling.

Umbilical Cord Practices of Members of the American College of Nurse‐Midwives

“…For example, years of clinical experience was significantly associated with cord milking practice. (21) 108 (11) 181 (19) 101 (10) 371 (38) Resuscitation required 965 195 (20) 63 7189 (20) 169 (18) 349 (36) Shoulder dystocia 959 209 (22) 107 (11) 162 (17) 115 (12) 366 (38) Abbreviations: FHR, fetal heart rate; NA, not applicable.…”

“…Furthermore, surveys and observations of provider practice show inconsistent uptake of these evidencebased methods. [18][19][20][21][22][23] Midwifery practice of DCC in the United States was first explored by Mercer et al in 2000. 24 The authors surveyed 157 members of ACNM and found that 69% practiced DCC (36% for 1-3 minutes and 33.1% for Ͼ3 minutes).…”

Geciktirilmiş Umbilikal Kordon Klemplemenin Yenidoğan Sağlığına Etkisi

“…Ülkemizde yapılan, plasenta ve umbilikal kordon hakkında verilen interaktif eğitimin etkinliğinin değerlendirildiği bir çalışmada; ebelerin plasenta ve umbilikal kordon ile ilgili bilgilerinin yeterli olmadığı, verilen eğitim ile bilgi puanlarının yükseldiği ve yenidoğana bakım veren ebelerin bilgi olarak güçlendirilmesi gerektiği sonucu çıkarılmıştır (1). Kadın doğum hekimleri ve ebelerin kordon klempleme uygulaması ve bu uygulamaya yönelik tutumlarına yönelik yapılan bir çalışmada pozitif basınçlı ventilasyon gerektiren bebekler için GKK'nin yararları konusunda daha düşük seviyelerde bir anlaşma bildirilirken, katılımcıların çoğunluğu (%69-71), GKK'nin hem term hem de preterm bebekler için faydalı olduğunu ifade etmişlerdir (46). Kanada'da yapılan bir çalışmada; kadın doğum hekimlerinin çoğunluğunun (%77,9), aile hekimlerinin %60'ının ve ebelerin %9,8'inin term bebeklerin kordonunu hemen klempleyip kestiği (<30 saniye) ve kadın doğum hekimlerinin %6,5'i, aile hekimlerinin %9,1'i ebelerin %65,7'sinin doğumdan iki dakika ya da daha fazla sonra GKK'yi uyguladıkları tespit edilmiştir.…”

Strategies for implementing placental transfusion at birth: A systematic review

“…[20][21][22][23][24][25][26][27] This review aimed to answer the questions: (a) What strategies are used to implement delayed cord clamping or cord milking in different settings around the world? [20][21][22][23][24][25][26][27] This review aimed to answer the questions: (a) What strategies are used to implement delayed cord clamping or cord milking in different settings around the world?…”

“…It is important to note that there are very limited data on rates of placental transfusion practice on a global scale, with current evidence from small published surveys and one systematic review indicating adoption of practice is poor. [20][21][22][23][24][25][26][27] This review aimed to answer the questions: (a) What strategies are used to implement delayed cord clamping or cord milking in different settings around the world? (b) What measures are taken to evaluate and improve delayed cord clamping or cord milking compliance?…”