| Concerns about umbilical cord clamping |
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| Home -------- Site Map Apgar Oxygen an urgent ongoing need Transition fetal to postnatal circulation Tradition Protocols Outcomes >>Concerns (NCS p5) Question Authority References Links Notes Contact: Eileen Nicole Simon eileen4brainresearch@yahoo.com |
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| Recent change of opinion |
Hypovolemic shock |
Ischemic brain damage |
Language development |
Evidence versus opinion |
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| "After waiting until the pulsation in the exposed umbilical cord has ceased, the child is severed from its mother." – Greenhill 1951, p 251 [49]. |
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| " The cord is cut after about three minutes or after it collapses." – Greenhill 1955, pp280-282 [50]. |
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| "After pulsation in the exposed cord has ceased, using dull scissors, the child is separated from its mother." – Greenhill 1965, p 376 [51] |
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| "The cord is clamped and divided as soon as pulsations have ceased." – Garrey et al. 1974, p359 [52] |
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| "The umbilical cord should be tied up after its vessels stop pulsating, which occurs in 2-3 min following the delivery of the infant." – Bodyazhina 1983, p 156 [53]. |
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| "Q: What is the significance of continued pulsation of the arteries in the umbilical cord at birth? |
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| A: It means that respiration has not commenced. The physiological stimulus causing closure of umbilical arteries (and ductus arteriosus) is an increase in oxygen saturation of the blood which occurs when the lungs expand with air." – Beischer et al. 1986, p 710 [54]. |
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| 4. Recent change of opinion Reasons for clamping the cord early were stated in many of the above textbooks. Cord around the neck occurs in about one out of every four births, and though efforts to loosen the loop are usually encouraged, often the advice was to clamp the cord to hasten delivery. Eastman, editor of the tenth edition of William's Obstetrics in 1950 cited other factors such as apnea from anesthesia, quick repair of the episiotomy, and management of the third stage of labor: |
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| "Whenever possible, clamping or ligating the umbilical cord should be deferred until its pulsations wane or, at least, for one or two minutes. |
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| Posted: February 27, 2006 (a work in progress) |
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