Childbirth practices, protocols, or "standards of care"

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Apgar scores of 8, 9, or 10

Published protocol

WAIT A MINUTE

Cochrane Review

Comments on the Cochrane Review

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Slow birth

Dr. Philip in his reply to our letters in response to the "WAIT A MINUTE" article cites the Cochrane Review on umbilical cord clamping, the summary of which is copied below, along with a link to where the full report can be obtained.

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Note that the review begins with the premise that umbilical cord clamping is the normal thing to do, and to do within seconds after birth; and, that early clamping allows immediate resuscitation of the infant, as if this is routinely required.  The Cochrane review only includes investigations more recent than 1965, thus misses the important results of research done when most obstetricians believed it was important to wait for pulsations in the cord to cease.

Scroll down to the authors' conclusions:

"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. There are no clear differences in other outcomes."

But, what outcome could be more important than preventing intraventricular hemorrhage (i.e. permanent damage within the brain)?

The "plain language" summary at the end states that "delayed" cord clamping for babies born early improves their health.  Explanation is then given that transfer of blood from the placenta to the lungs takes place if the cord is left "unclamped."

Posted: February 27, 2006 (a work in progress)

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Cochran Review abstract:

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