|Childbirth practices, protocols, or "standards of care"
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an urgent ongoing need
fetal to postnatal circulation
Contact: Eileen Nicole Simon
|Apgar scores of
8, 9, or 10
|WAIT A MINUTE
||Comments on the
|"Slow birth" was Apgar's term for the traditional practice of waiting for pulsations in the
umbilical cord to cease. This tradition was replaced by an increasing trend during the
1930s and 1940s to clamp the cord as soon as possible after birth.
|Apgar scores of 8, 9, or 10
|By the year 2000, the published standard of care mandated double clamping of a cord
segment (10-20 cm) immediately after birth in all deliveries, for blood acid-base analysis,
but which can be discarded if the 5-minute Apgar score is deemed satisfactory.
|WAIT A MINUTE
|The protocol published in 2000 was modified in 2004 with the suggestion that clamping
should be delayed a minimum of 30 to 45 seconds in preterm infants, to allow for some
fetoplacental circulation to prevent development of respiratory distress syndrome.
|A Cochrane Database review of research on umbilical cord clamping in 2004 determined
that delaying cord clamping by 30 to 120 seconds, rather than early clamping, seems to
be associated with less need for transfusion and less intraventricular haemorrhage.
|Comments on the Cochrane Review
|The Cochrane Review on early versus delayed cordclamping was published in 2006.
The research reports reviewed go back no further than 1965, thus important data from
many studies going back over a century are not included
|Posted: February 27, 2006
(a work in progress)
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