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A physiologic approach to cord clamping: Clinical issues
1Section of Neonatology, University of Colorado School of Medicine, 13121 E. 17th Avenue, Mail Stop 8402, Aurora, CO 80045 USA.
Maternal Health, Neonatology and Perinatology
|April 9, 2016
Summary
Delayed umbilical cord clamping, considering infant respirations, offers benefits but requires more research for optimal practice. Current guidelines lack clarity for delivery room dilemmas.
Area of Science:
- Neonatal Physiology
- Obstetrics
- Perinatal Medicine
Background:
- Umbilical cord clamping is evolving from a time-based to a physiological process.
- This shift considers circulatory changes and infant respiration onset.
- Existing evidence is insufficient for optimizing management strategies.
Purpose of the Study:
- To review evidence on physiological outcomes of delayed cord clamping and cord milking versus immediate clamping.
- To identify gaps in current knowledge regarding cord clamping practices.
Main Methods:
- Review of experimental physiology data.
- Analysis of a large, population-based observational study.
- Examination of evidence on physiological outcomes.
Main Results:
- Current guidelines offer varied recommendations and lack practical advice for delivery room scenarios.
- Evidence highlights physiological outcomes of delayed vs. immediate cord clamping.
- Gaps exist in determining optimal clamping time and interventions for non-breathing or severely asphyxiated infants.
Conclusions:
- Further research is necessary to inform behavioral and technological changes.
- These changes are crucial for promoting the adoption of safe, physiologic cord clamping practices.
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