Amer J Perinatol 2017; 34(11): 1048-1053
DOI: 10.1055/s-0037-1603591
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Delayed Umbilical Cord Clamping at <32 Weeks' Gestation: Implementation and Outcomes

Janine S. Rhoades1, Tatiana Bierut1, Shayna N. Conner1, Methodius G. Tuuli1, Zachary A. Vesoulis2, George A. Macones1, Alison G. Cahill1
  • 1Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
  • 2Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
Further Information

Publication History

27 April 2017

28 April 2017

Publication Date:
25 May 2017 (eFirst)

Abstract

Objectives This study aims to evaluate the implementation of a delayed umbilical cord clamping (DCC) protocol for neonates <32 weeks. Secondarily, to evaluate the impact of DCC on maternal outcomes and on the ability to obtain umbilical cord blood gases.

Study Design Retrospective cohort study from November 2014 to March 2016 of patients delivered by 316/7 weeks. In 2014, an institutional protocol for DCC at <32 weeks was implemented. We assessed adherence to the protocol and compared adverse maternal outcomes (utilizing a hemorrhage composite). We evaluated the impact of DCC on the ability to obtain adequate umbilical cord blood gas specimens.

Results Of the 185 patients included in the study, 90 underwent DCC, and 72% of potentially eligible patients appropriately received DCC. There was no significant difference in the maternal hemorrhage composite outcome between DCC and immediate cord clamping (23.3 vs. 36.8%, adjusted odds ratio = 0.64, 95% confidence interval = 0.33, 1.26). There was also no significant difference in the ability to obtain a single or paired umbilical cord blood gas result.

Conclusion Implementation of a DCC protocol for preterm neonates is feasible and was successful. We did not find an increase in maternal risk or a decrease in the ability to obtain umbilical cord blood gases following DCC.

Note

Poster presented at the 37th Annual Meeting of the Society for Maternal–Fetal Medicine; January 23–28, 2017; Las Vegas, NV.