Delayed cord clamping in the compromised baby

Abstract

Compromised babies are routinely immediately separated from the umbilical cord in order to be resuscitated. The benefits of delayed cord clamping are numerous and apply as much, if not more, to the non-breathing baby, thus it is important to ask 'does early cord clamping cause harm?' The evidence suggests that early cord clamping can cause bradycardia in the baby and create the need for resuscitation. Invasive measures such as drugs and volume expanders are not required as frequently when delayed cord clamping is practised. Allowing the placenta to perform its role in the resuscitation means that oxygen supply continues, despite the failure to achieve effective respiration immediately. There appears to be no adverse psychological affects for the mother and birth partner if adequate midwifery support is provided. As midwives we must use the best available evidence to support our practice and improve outcomes.

Standards for maternity care professionals attending planned upright breech births: A Delphi study

“…The panel's consensus that professionals attending physiological VBBs should be able to initiate resuscitation with the umbilical cord still attached is also in line with emerging trends in neonatal management. Gruneberg and Crozier (2015) suggest that delayed cord clamping may be just as important if not more to the potentially compromised infant as the UK Resuscitation Council and national intrapartum guidance suggest it is for uncompromised infants (NICE, 2014; Resuscitation Council (UK), 2010).…”