Cardiac Output, Low Clinical Trial
Official title:
Hemodynamic Effects of Delayed Umbilical Cord Clamping in Full-term Newborns
The sequence of events at the time of delivery includes delivery of the infant, clamping of
the umbilical cord, and lastly delivery of the placenta. There are some benefits for delayed
cord clamping. This study aims to compare the effects of two different duration of delayed
cord clamping.
Infants will be randomized into two groups based on the duration of delayed cord clamping: 30
seconds vs 120 seconds. Different hemodynamic effects will be measured in each group at
different time intervals. The hypothesis of the study is that delayed cord clamping for 120
seconds is associated with better cardiac output and with other hemodynamic advantages.
The study will include full term infants delivered via cesarean section. Written informed
consent for participation in the study will be obtained from parents prior to delivery.
Newborns will be randomly assigned into two groups according to the duration of cord
clamping: Group 1: the cord will be clamped at 30 seconds, and Group 2: the cord will be
clamped at 120 seconds of life. Stopwatch will be started when infants buttocks (or head if
breech) are delivered from the uterus. The time elapsed will be counted aloud by the
investigator in 10-second intervals. During this time, the infant will be held in linen on
the mothers legs. Care will be taken not to apply traction on the cord. Milking of the cord
will not be allowed. Immediately after resuscitation, infants will be attached to the leads
of the electrical cardiometry device. Device output will be imported at 5, 10, and 15 minutes
after birth in both groups. A follow up measurement will be imported later at 24 hours of
age. In addition, a peripheral blood sample will be obtained at 24 hours of age for
assessment of hemoglobin, glucose and bilirubin concentrations. .
The calculated sample size is 31 newborns in each group. This number will be adequate to
detect an effect size of 10% in the mean cardiac output between the two groups with 95%
confidence and 80% power. The study plans to recruit 34 infants in each group (10% attrition
rate).
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