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Delayed Cord Clamping In Very Low Birth Weight Infants

Delayed Cord Clamping In Very Low Birth Weight Infants. Melissa Reljac , SNNP. What is it?. The delaying of clamping the umbilical cord in a preterm infant. Routine immediate clamping of the umbilical cord has been standard procedure. Appropriate delay times range from 10-60 seconds or more.

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Delayed Cord Clamping In Very Low Birth Weight Infants

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  1. Delayed Cord Clamping In Very Low Birth Weight Infants Melissa Reljac, SNNP

  2. What is it? • The delaying of clamping the umbilical cord in a preterm infant. • Routine immediate clamping of the umbilical cord has been standard procedure. • Appropriate delay times range from 10-60 seconds or more.

  3. BackgroundInformation: • Research proving the benefits of delayed cord clamping. • Efforts to incorporate delayed clamping into standard practice have proven difficult. • Higher survival rates among preterm infants who were allocated the delay • Common practice has been immediate clamping of the cord.

  4. Goals • Delayed cord clamping reduces: • blood transfusions • intreventricular hemorrhage • instances of late onset sepsis

  5. Intraventricular Hemorrhage • Condition occurs in nearly half of preterm infants weighing 500-700g • Occurs in the germinal matrix, particularly vulnerable in the first 48 hrs of life. • Delayed cord clamping showed a significant reduction in IVH • Study of preterm infants 24-31 weeks, clamping was delayed for a max of 120 seconds for infants 37 weeks or less.

  6. Decrease Need For Transfusions • Reduction in blood transfusion where anemia or low blood pressure was involved. • Contributed to the increase and improved circulation of blood volume and better blood pressure control. • Hypovolemia is associated with immediate cord clamping

  7. Late Onset Sepsis • Non conclusive evidence in the reduction of late onset sepsis. • Some studies have shown that delayed cord clamping is more effective in preterm males for decreasing late onset sepsis (Mercer, 2006

  8. Other Benefits • Progenitor cells which contain developmental and reparative properties. • Higher core body temperatures. • Higher concentrations of iron.

  9. Questions?

  10. References • Cassady, G., & Rosenkrantz, T. (2011). Anemia of Prematurity. Medscape Medical News. Retrieved from: http://emedicine.medscape.com/article/978238-overview • Cavaliere, T. (2004). Red blood cell indices: Implications for practice. Medscape Medical News. Retrieved from: http://www.medscape.com/viewarticle/497032 • Eichenbaum-Pikser, G. & Zasloff, J. (2009). Delayed clamping of the umbilical cord: A review with implications for practice. Journal of Midwifery and Women’s Health, 5(4): 321-26. Retrieved from:  http://www.medscape.com/viewarticle/708616

  11. References • Hansen, T. & Rosenkrantz, T. (2012). Neonatal Jaundice. Medscape Medical News. Retrieved from: http://emedicine.medscape.com/article/974786-overview#a0104 • Kling, J. (2010). Delayed cord clamping may benefit at-risk infants. Medscape Medical News. American Academy of Pediatrics (AAP) 2010 National Conference and Exhibition. Retrieved from: http://www.medscape.com/viewarticle/730138 • Mercer, J., Vohr, B., Erickson-Owens, D., Padbury, J., & Oh, W. (2009). Seven-month developmental outcomes of very low birth weight infants enrolled in a randomized controlled trial of delayed versus immediate cord clamping. Journal of Perinatology. Retrieved from: http

  12. References • Mercer, J., Vohr, B., McGrath, M., Padbury, J., Wallach, M., & Oh, W. (2006). Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late onset sepsis: A randomized, controlled trial. Pediatrics, 117(4): 1235-1242. Retrieved from: http • Rabe, H., Reynolds, G., & Diaz-Rosello, J. (2008). A systematic review and meta-analysis of a brief delay in clamping the umbilical cord of preterm infants. Neonatology, 93: 138-44. DOI: 10.1159/000108764. • Rabe, H., Reynolds, G., & Diaz-Rosello, J. (2004). Early versus delayed umbilical cord clamping in preterm infants. (Review). The Cochrane Collaboration, 4. Retrieved from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003248.pub2/pdf/standard

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