Delayed cord clamping: Time for physiologic implementation

Area of Science:

• Neonatal medicine
• Perinatal care
• Obstetrics

Background:

• Delayed cord clamping (DCC) is recognized for its benefits in both preterm and term neonates.
• Current clinical guidelines for DCC lack consistency across institutions, leading to non-standardized practices.
• Physiologic-based cord clamping (PBCC) has been introduced as an alternative approach.

Purpose of the Study:

• To review the benefits and variations in delayed cord clamping practices.
• To compare the physiological effects of DCC and cord milking.
• To assess the safety and efficacy of different cord management techniques in neonates, particularly preterm infants.

Main Methods:

• Literature review of studies on delayed cord clamping and cord milking.
• Analysis of physiological effects and clinical outcomes associated with each method.
• Comparison of existing practice guidelines and their standardization.

Main Results:

• Delayed cord clamping demonstrates benefits for both preterm and term infants.
• Significant variability exists in the implementation and standardization of DCC protocols.
• Cord milking presents distinct physiological effects that may be detrimental to preterm infants.

Conclusions:

• Standardization of delayed cord clamping is crucial for optimizing neonatal outcomes.
• Physiologic-based cord clamping requires further investigation, especially regarding cord milking's safety in preterm neonates.
• Consistent guidelines are needed to ensure the safe and effective application of cord management techniques.