Less Residual placental blood volume left when cord pulsation ceases than when early cord clamping at 60 seconds

Abstract

Less Residual placental blood volume left when cord pulsation ceases than when early cord clamping at 60 seconds H.Y. Zhang1, Y. Wu2, R. Guo3, M. Huang1, Y. Ling4, Y.H. Huang5 1School of Nursing, Hainan MedicaI University, Hainan (P.R. China) 2Delivery room of Hainan Maternal and Neonatal Hospital, Hainan (P.R. China) 3Director of Nursing Department, Department of Obstetries, Haikou Maternal and Child Health Hospital, Haikou (P.R. China) 4Department of Obstetrics and Gynecology, Affiliated Hospitai of Hainan MedicaI University, Haikou (P.R. China) 5Center far Assisted Reproduction, Hainan MedicaI University, Longhua Road, Haikou (P.R. China) Summary Objectives: Our goal was to test the volume of residual placental blood volume (RPBV) left with delayed cord clamping occurring when pulsation of the umbilical artery ceases as compared to early cord clamping at 60 seconds along with an assessment of its effects on maternal and neonatal outcomes. Materials and Methods: From March to June 2015 in Haikou maternal and child health hospital, 403 single-term patients with normal vaginal births and healthy babies were enrolled with randomization into two groups. The experimental group (n = 201) received delayed cord clamping after pulsation of the umbilical artery ceased with the control group (n = 202) having the umbilical cord cut at exactly 60 seconds. RPBV was collected when the cord was cut in both groups. Maternal and neonatal conditions were recorded. Results: In the control group, RPBV per birth weight (RPBV (mL/kg) range) [21.0 14.9 (2.9-73.2)] was higher than that in experimental group [4.3 3.5 (0.8 - 19.1)] (p < 0.01); peak total serum bilirubin (TSB) level (mg/dL) [(13.6 3.5) (5.0 - 20.7) mg/d1] was higher in the control than that in experimental group [11.9 2.9 (4.5 - 24.5)] (p < 0.01); and postpartum blood loss in control group [(187.8 104.6) (80-650.00) mL] was higher than that in experimental group [(160.2 72.9) (70 - 450) mL] (p = 0.02). Maternal age, gestational age and Apgar score at one and five minutes were not of statistically different between groups. No neonatal deaths were recorded in either group at one month’s follow up. Conclusions: Delayed cord clamping until the umbilical artery pulsation ceased is a safe intervention and reduces the residual placental blood volume without any adverse maternal or neonatal effects. The data suggests that more placental transfusion occurs in the newborn with delayed cord clamping. Key words: Residual placental blood volume (RPBV); Delayed cord clamping (DCC); Early cord clamping (ECC); Placental neonatal transfusion; UCB bank.