Introduction
During gestation in the mid-term, the blood is equally distributed due to the relatively large size of the placenta compared to the fetus. And by the full term, one-third of the blood flows through the placenta and two-thirds through the fetus. All these factors are essential to determine whether to proceed with early or delayed cord clamping. Blood volume loss is an important criterion that decides early or late cord clamping in preterm babies. In preterm delivery cases, it is better to delay the cord clamping as it reduces the potential risks to both woman and the baby.
What Is the Umbilical Cord?
The umbilical cord adjoins the baby to the placenta of the mother. During gestation, the umbilical cord supplies nutrients to the fetus for growth and development. After the delivery of the fetus, the cord is clamped and cut. After the baby's delivery, between one to three weeks, the cord dries up and falls off naturally.
What Is Early Cord Clamping?
Early cord clamping means clamping and cutting the cord within the first minute after birth. This procedure has traditionally been used in many hospitals. The reason for early cord clamping is that it allows the physician to attend to the baby quickly and resolves any potential problems that may occur at birth.
What Is Delayed Cord Clamping?
On the other hand, delayed cord clamping involves waiting a few minutes before clamping and cutting the cord. Delayed cord clamping is done within one to three minutes or when the pulsations of the cord have stopped. This allows the baby to continue receiving oxygen and nutrients from the placenta through the umbilical cord.
How Is the Cord Clamping Procedure Done?
In cases other than lotus birth (the procedure of leaving the cord so that it falls on its own), the umbilical cord is clamped near two places, one near the baby's belly button and the other farther away from the cord. The umbilical cord is cut between these clamps.
What Are the Benefits of Early Cord Clamping in Preterm Delivery Cases?
In the case of preterm delivery (birth before thirty-seven weeks of pregnancy), early cord clamping may be recommended in certain circumstances to help stabilize the newborn's condition.
There are some benefits to early cord clamping in preterm infants, including:
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Increased Oxygenation: By clamping the cord early, the infant receives a greater volume of blood from the placenta, which can help improve oxygenation and stabilize the baby's condition.
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Reduced Risk of Bleeding: Preterm infants are at elevated risk of bleeding in the brain (intracranial hemorrhage), and early cord clamping may help reduce this risk.
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Improved Transfer To Neonatal Intensive Care Unit (NICU): Early cord clamping can facilitate the transfer of infants to the NICU, where specialized care is available.
What Are the Risks of Early Cord Clamping in Preterm Deliveries?
However, there are also some potential drawbacks to early cord clamping in preterm infants, including:
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Lower Iron Stores: Preterm infants are at increased risk of iron deficiency, and clamping the cord early can reduce iron stores in the infants.
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Increased Risk of Neonatal Anemia: Clamping the cord early can also elevate the risk of neonatal anemia, a condition in which the newborn has a low number of red blood cells.
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Delay in Breastfeeding: Early cord clamping may interfere with the newborn's breastfeeding ability, as it can disrupt the milk production process.
What Are the Benefits of Delayed Cord Clamping?
Delayed cord clamping has been shown to have several potential benefits for the baby, including:
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Increased Iron Stores: Delayed cord clamping allows the baby to receive a larger volume of placental blood containing iron. This can help prevent iron deficiency anemia in the baby.
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Improved Cardiovascular Function: Delayed cord clamping has been shown to improve the baby's blood pressure and heart rate.
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Enhanced Brain Development: Some studies have suggested that delayed cord clamping may be associated with improved neurodevelopment in babies.
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The benefits of delayed cord clamping are greatest for preterm infants and those born at term with low birth weight. In these cases, delayed cord clamping may be particularly beneficial in improving outcomes such as blood pressure and iron stores.
What Are the Risks of Delayed Cord Clamping in Preterm Deliveries?
There are some risks of delayed cord clamping in preterm deliveries:
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Elevated Risk of Bleeding: Preterm babies are at an elevated risk of bleeding in the brain and intracranial hemorrhage. The late cord clamping increases this risk.
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Delayed Transfer To Neonatal Intensive Care Unit (NICU): The late cord clamping leads to a delay in the transfer of the newborn to the NICU.
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Jaundice: There is an elevated risk of jaundice in newborns after delayed umbilical cord clamping and this requires phytotherapy treatment.
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There is a reduced risk of postpartum hemorrhage.
In Which Cases Is the Delayed Cord Clamping Not Recommended?
In many cases, delayed cord clamping has many benefits and is recommended. Delayed cord clamping is recommended in the circumstances such as
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If the woman during the delivery is bleeding heavily and requires immediate medical attention, then delayed cord clamping is done.
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If there is some issue with the placenta, like the placenta previa (the placenta is partially or fully covering the cervix that leads to uncontrolled bleeding), placenta abruption (the placenta separates from the uterus before the delivery), placenta accreta (the placenta develops too deep into the uterine wall) and placenta increta (the placenta develops too deep into the uterus).
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The umbilical cord is bleeding, and the blood is not supplied to the baby.
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If the infant needs support to breathe.
Conclusion
It is important to note that both early and delayed cord clamping have risks and benefits, and the optimal timing of cord clamping may depend on the specific circumstances of the birth. Discussing the options with the physician and making the right decision for the woman and her baby is essential. Early cord clamping is generally done in many cases. But recent studies suggest that delayed cord clamping in preterm deliveries offers many benefits. Delayed cord clamping allows more blood and nutrients to reach the brain and improves brain development and functions.
