Umbilical Cord Management and Stump Care in Normal Childbirth in Slovenian and Croatian Maternity Hospitals

Mivšek, Ana Polona; Petročnik, Petra; Skubic, Mitja; Zakšek, Teja; Došler, Anita Jug

doi:10.20471/acc.2017.56.04.27

Cited by 4 publications

(1 citation statement)

References 2 publications

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“…The optimum time to clamp the umbilical cord has not been established yet 2,8,9,24 . In another study, 69.3% of professionals clamped the cord once it stopped beating.…”

Section: Discussionmentioning

confidence: 99%

Variability and associated factors in the management of cord clamping and the milking practice among Spanish obstetric professionals

Ortiz‐Esquinas¹,

Gómez‐Salgado

Pascual-Pedreño³

et al. 2020

Sci Rep

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clinical practice guides recommend delayed clamping of the umbilical cord. if this is not possible, some authors suggest milking as an alternative. the objective of this study was to determine the variability in professional practice in the management of umbilical cord clamping and milking and to identify factors or circumstances associated with the different methods. An observational cross-sectional study done on 1,045 obstetrics professionals in Spain in 2018. A self-designed questionnaire was administered online. the main variables studied were type of clamping and use of milking. crude odds ratios (oR) and adjusted odds ratios (ORa) were estimated using binary logistic regression. 92.2% (964) performed delayed clamping. 69.3% (724) clamped the cord when it stopped beating. 83.8% (876) had heard of milking, and 55.9% (584) had never performed it. Professionals over 50 were less likely to perform delayed clamping, with an ORa of 0.24 (95% CI: 0.11-0.52), while midwives were more likely to perform delayed clamping than obstetricians, with an ORa of 14.05 (95% CI: 8.41-23.49). There is clinical variability in the management of umbilical cord clamping and the use of milking in normal births. part of this variability can be attributed to professional and work environment factors. Umbilical cord clamping and cutting are done in the third stage of labour. Two types of clamping have been described, depending on how long after birth they are performed: early and delayed. In early umbilical cord clamping (ECC), the cord is clamped within the first minute after birth, while in delayed cord clamping (DCC), the clamping is done between one and three minutes of birth, or when the cord stops beating 1-4. It should be pointed out that, since 2010, ILCOR recommend that the cord should not be clamped within one minute 5. Among the advantages for the newborn, it has been observed that DCC in term newborns resulted in increased levels of haemoglobin at birth and, consequently, better iron levels in the first few months of life, which can have a favourable impact on the child's development 6-9. In the case of preterm newborns, a reduction in rates of intraventricular haemorrhage and necrotising enterocolitis has been observed, as well as a reduced need for transfusion. If ECC is performed, there is an increase in the mortality rate with respect to DCC 10. However, an increased risk of jaundice has been described 11. With regard to mothers, in 2013, McDonald et al. concluded that DCC was not related to an increased risk of postpartum haemorrhage (PPH) or a difference in postpartum haemoglobin levels compared with early clamping 2. Due to the impact that clamping has on maternal-foetal health 3,6,8-11 international Clinical Practice Guides (CPGs) recommend this procedure DCC in all births, when possible 12-15. When DCC is not possible for any reason, such as immediate neonatal resuscitation or maternal haemodynamic instability, umbilical cord milking (UCM)has been proposed as an alternative option to DCC. This technique consists of ...

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“…The optimum time to clamp the umbilical cord has not been established yet 2,8,9,24 . In another study, 69.3% of professionals clamped the cord once it stopped beating.…”

Section: Discussionmentioning

confidence: 99%

Variability and associated factors in the management of cord clamping and the milking practice among Spanish obstetric professionals

Ortiz‐Esquinas¹,

Gómez‐Salgado

Pascual-Pedreño³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

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Women's perspectives on the quality of hospital maternal and newborn care around the time of childbirth during the COVID‐19 pandemic: Results from the IMAgiNE EURO study in Slovenia, Croatia, Serbia, and Bosnia‐Herzegovina

Kurbanović

Covi

Valente

et al. 2022

Intl J Gynecology & Obste

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Care at the first postnatal hour in two hospitals of the Adequate Birth Project: qualitative analysis of experiences in two stages of the Healthy Birth research

et al. 2023

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Background The Adequate Childbirth Project (PPA) is a quality improvement project that aims to enhance normal delivery and reduce cesarean sections with no clinical indication in the Brazilian supplementary health care system. This study aims to analyze the care model of the first postpartum hour in hospitals that participated in the PPA. Methods Qualitative analysis based on the narrative of 102 women attended at two hospitals participating in the evaluative “Healthy Birth” research that analyzed the degree of implementation and the effects of the PPA. We assessed three practices within the first hour after delivery: skin-to-skin contact, breastfeeding and appropriate clamping of the umbilical cord. Data was collected through semi-structured interviews by telephone and submitted to thematic content analysis. Results The categories that emerged from the analysis of the results were “Dimension of time and care expressed in the lived experience” and “Interferences in care in the first hour of life”. In the first category, women reported that in the first hour after delivery the newborn was placed on the mother's chest, but the length of time of the newborn's stay in skin-to-skin contact was less than one hour. This experience, even in a shorter period of time, was said to be positive by the women interviewed. Two barriers were observed: interruption of skin-to-skin contact for neonatal care and the transfer to the recovery room, both separating baby from mother without observing the duration of the "golden hour". It was identified that a process of improvement of the quality of care for childbirth is underway, with a gradual incorporation of recommended practices for care in newborn's first hour of life. Conclusions Women reported access to the three care practices at two hospitals participating in the PPA quality improvement project. All practices were valued by women as a positive experience and should be promoted. Information during antenatal care to increase women´s autonomy, review of hospital practices to reduce barriers, and support from health care providers during the first hour after birth are needed to improve the implementation of these practices and access to their health benefits.

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Umbilical Cord Management and Stump Care in Normal Childbirth in Slovenian and Croatian Maternity Hospitals

Cited by 4 publications

References 2 publications

Variability and associated factors in the management of cord clamping and the milking practice among Spanish obstetric professionals

Variability and associated factors in the management of cord clamping and the milking practice among Spanish obstetric professionals

Women's perspectives on the quality of hospital maternal and newborn care around the time of childbirth during the COVID‐19 pandemic: Results from the IMAgiNE EURO study in Slovenia, Croatia, Serbia, and Bosnia‐Herzegovina

Care at the first postnatal hour in two hospitals of the Adequate Birth Project: qualitative analysis of experiences in two stages of the Healthy Birth research

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