Umbilical Cord
been concerns that it could increase the risk of
Clamping Should
Be Delayed, Says
Expert
ScienceDaily (Aug. 17, 2007) —
Clamping and cutting of the
umbilical cord should be delayed for
three minutes after birth, particularly
for pre-term infants, suggests a
senior doctor writing in the British
Medical Journal.
Early clamping and cutting of the
umbilical cord is widely practiced as part of the
management of labour, but recent studies
suggest that it may be harmful to the baby. The
rate of early cord clamping varies widely in
Europe, from 17% of units in Denmark to 90% in
France.
So Dr Andrew Weeks, a senior lecturer in
obstetrics at the University of Liverpool, looked
at the evidence behind cord clamping.
For the mother, trials show that early cord
clamping has no ill effects, he writes. But what
about the baby?
At birth, he says, the umbilical cord sends
oxygen-rich blood to the lungs until breathing
establishes. So as long as the cord is
unclamped, the average transfusion to the
newborn is equivalent to 21% of the neonate's
final blood volume and three quarters of the
transfusion occurs in the first minute after birth.
For babies born at term, the main effect of this
large autotransfusion is to increase their iron
status. This may be lifesaving in areas where
anaemia is endemic.
In the developed world, however, there have
polycythaemia and hyperbilirubinaemia
(abnormally high levels of red blood cells and
bile pigments in the bloodstream, often leading
to jaundice). But trials show this is not the case.
For pre-term babies the beneficial effects of
delayed clamping may be greater, he says.
Although the studies are smaller, delayed
clamping is consistently associated with
reductions in anaemia, bleeding in the brain
(intraventricular haemorrhage), and the need for
transfusion.
So how should we approach cord clamping in
practice, he asks?
In normal deliveries, delaying cord clamping for
three minutes with the baby on the mother's
abdomen should not be too difficult.
The situation is a little more complex for babies
born by caesarean section or for those who
need support soon after birth. Nevertheless, it is
these babies who may benefit most from a delay
in cord clamping. For them, a policy of 'wait a
minute' would be pragmatic, he says.
There is now considerable evidence that early
cord clamping does not benefit mothers or
babies and may even be harmful, he writes.
Both the World Health Organization and the
International Federation of Gynecology and
Obstetrics (FIGO) have dropped the practice
from their guidelines.
It is time for others to follow their lead and find
practical ways of incorporating delayed cord
clamping into delivery routines, he concludes.
References:
http://www.sciencedaily.com/releases/
2007/08/070816193328.htm
Summary:

The rate of early cord clamping varies widely in Europe, from 17% of units in Denmark to 90% in
France. So Dr Andrew Weeks, a senior lecturer in obstetrics at the University of Liverpool,
looked at the evidence behind cord clamping. And it found out that early cord clamping has no ill
effects on the part of the mother, but the question is, what about the baby?

At birth, he says, the umbilical cord sends oxygen-rich blood to the lungs until breathing
establishes. For babies born at term, the main effect of this large autotransfusion is to increase
their iron status. For pre-term babies the beneficial effects of delayed clamping may be greater,
he says. Although the studies are smaller, delayed clamping is consistently associated with
reductions in anaemia, bleeding in the brain (intraventricular haemorrhage), and the need for
transfusion. He asks, if how could we approach cord clamping in practice

In normal deliveries, delaying cord clamping for three minutes with the baby on the mother's
abdomen should not be too difficult.

There is now considerable evidence that early cord clamping does not benefit mothers or babies
and may even be harmful, he writes.

Reaction:

After expulsion of the baby, umbilical cord is immediately cut in order to provide baby
care for the newborn individual. This is the usual thing we observed in the delivery room. But
with the new research, delaying umbilical cord clamping is encourage in order to lower the risk
of having anemia, bleeding of the brain and the need for transfusion. It is believed that
prolonging the cutting of umbilical cord facilitates the transfusion of oxygen to the newborn form
his/her mother, this results to high reserves of iron in the body of the newborn which prevents
him/her from having anemia. Delaying has no ill effects on the part of the mother.

For me, I agree with the suggestion of the experts, there is no loss if we follow this,
“benefit outweighs risk”, delay of cutting for three minutes wouldn’t be difficult for the mother and
the child, moreover, the child gain the most benefits especially to preterm born babies. Here in
the Philippine setting, from the delivery to childbirth process, giving care to our clients is
somewhat a “rush” thing. Other concerns such as the example in this article were not
considered for the fact that we are behind from new studies, technology and budget. Hoping in
the future, our knowledge towards new trends in giving healthcare would enhance for us to
change the old practices into a new and effective ones.