Baby-directed umbilical cord clamping: A feasibility study
Douglas A Blank1, Shiraz Badurdeen1, C Omar F Kamlin2
1Newborn Research Centre, The Royal Women's Hospital, Melbourne, Australia; The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.
Resuscitation
|July 24, 2018
Summary
Delayed cord clamping (DCC) is standard for vigorous infants. A new method, Baby-Directed Umbilical Cord Clamping (Baby-DUCC), allows resuscitation during DCC for non-vigorous infants, proving feasible in a pilot study.
Area of Science:
- Neonatal resuscitation
- Perinatal care
- Obstetrics
Background:
- Over 5% of newborns require breathing assistance post-birth.
- Delayed cord clamping (DCC) is standard for vigorous infants but challenging for non-vigorous ones needing resuscitation.
- Baby-Directed Umbilical Cord Clamping (Baby-DUCC) aims to enable resuscitation during DCC.
Purpose of the Study:
- To assess the feasibility of the Baby-DUCC technique.
- To evaluate the ability to provide respiratory support during DCC.
- To analyze maternal and infant outcomes during the Baby-DUCC procedure.
Main Methods:
- Feasibility study involving infants born at ≥32 weeks gestation.
- Umbilical cord clamped ≥60 seconds after CO2 detector turned yellow if respiratory support was needed.
- Maternal and infant outcomes recorded in the delivery room and before discharge.
Main Results:
- Forty-four infants enrolled; 12 were non-vigorous.
- All infants achieved heart rates >100 BPM by 80 seconds.
- Median clamping times were 150s (vigorous) and 138s (non-vigorous).
- Median maternal blood loss was 300ml.
Conclusions:
- Baby-DUCC is a feasible technique for providing resuscitation during delayed cord clamping.
- This method allows umbilical cord clamping based on infant physiological readiness.
- Feasible for both vaginal and cesarean births in term and near-term infants.
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