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Updated: Aug 6, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Hemodynamic effect of delayed cord clamping versus early cord clamping in preterm twins using echocardiography: a
Floriane Brief1, Anie Lapointe1, Gabriel Altit2
1Division of Neonatology, Department of Pediatrics, CHU de Sainte Justine, Université de Montréal, Montreal, QC, Canada.
Background:
To compare echocardiographic metrics in preterm twins who underwent delayed cord clamping (DCC) versus early cord clamping (ECC).
Methods:
Prospective observational cohort study conducted at CHU Sainte Justine in Montreal involving preterm neonates between 24 and 36 weeks of gestational age. Neonates with congenital malformations, twin-to-twin transfusion syndrome, and the need of ECC for resuscitation were excluded. Echocardiography assessed the systemic blood flow.
Results:
63 twins were included: 47 neonates receiving DCC, and 16 undergoing ECC. Superior vena cava (SVC) blood flow was comparable between the DCC and ECC groups at 6-9 h (78 ± 26.9 vs. 62 ± 20.1 mL/kg/min; p = 0.08) and 24-48 h (106 ± 31.2 vs. 87 ± 23.1 mL/kg/min; p = 0.07). Left ventricular output (LVO) was higher in the ECC group at 24-48 h (153 ± 30 vs. 187 ± 66 mL/kg/min; p = 0.01). TAPSE Z-score was higher in the DCC group at 24-48 h (-0.1 ± 1.9 vs. -1.1 ± 2.2 cm, p = 0.04). Systolic velocity of the right ventricle lateral wall was higher in the DCC group.
Conclusion:
In preterm twins, DCC was associated with improved echocardiographic indicators of cardiovascular stability and improved right ventricular function suggesting a potential benefit of DCC in this population.
Impact:
This prospective study implies a potential benefit of delayed cord clamping in a population of preterm twins and suggests to perform delayed cord clamping in this population.
