Residual Placental Blood Volume Estimation to Measure the Increase in Neonatal Blood Transfer by Delayed Cord Clamping: A Quasi-Experimental Study QC01-QC05
Dr. Geetanjali Mahagundappa Katageri,
Associate Professor, Department of OBG, S.Nijalingappa Medical College, Bagalkot, Karnataka, India.
Introduction: Iron deficiency and iron deficiency anaemia are common in newborns and children in India. Iron is essential for the physical, mental and even emotional growth of the child. Breast milk is not rich in iron and is not enough to provide the requisite amount of iron to the baby. Though WHO recommends delayed clamping of the cord in all developing countries, this is rarely a routine practice.
Aim: To practically demonstrate the increase in neonatal blood transfer by adopting the practice of delayed cord clamping.
Materials and Methods: This was a quasi-experimental study conducted at a tertiary care centre in Bagalkot, Karnataka between July and September 2014. The study was conducted in two phases, with the first phase not attempting any change of existing practices. Halfway through the study, the birth attendants were asked to change the timing of clamping whenever possible, to after stoppage of cord pulsations. Maternal characteristics were recorded. Timings of the various events during labour were noted. Residual placental blood volume was estimated in all cases by allowing the cut end of the cord to bleed. The results were analysed using t-test.
Results: A total of 172 deliveries occurred during the period of observation, out of which 117 fulfilled the inclusion criteria. There were no significant differences in the maternal characteristics in the two groups (early cord clamping versus delayed cord clamping). There was an average difference of 44 mL in the residual placental blood volume (more in the early clamping group), which was statistically significant. The babies in the delayed clamping group had a higher average birth weight, which was also statistically significant. Unexpected complications interfering with a prior decision of delayed cord clamping were relatively few.
Conclusion: Delayed cord clamping significantly increases the volume of blood transferred to the baby. Adopting this practice routinely, as recommended, requires minimal extra efforts on the part of the birth attendants, and should be stressed on.