Postpartum Haemorrhage Clinical Trial
Official title:
Timing of Umbilical Cord Occlusion in Premature Babies( <33 w). Delayed vs Early.
Early cord clamping after delivery has been common practice for many decades as part of the
active management of the third stage of labour. However in recent years, several studies
have shown that delayed cord clamping may offer important benefits to the newborn. The data
gathered indicate that delayed cord clamping may be particularly useful in premature babies,
between 26 and 32 weeks of gestational age, reducing the need for blood transfusion and the
incidence of intraventricular haemorrhage.
However it is argued that the described potential benefits of delayed cord clamping could be
negated by the increased risk of polycythaemia and jaundice in the newborn, as well as by
potential interference with the postpartum haemorrhage management, initial care and
reanimation of the premature newborn, and the possibility of cord blood donation. These
factors, together with as the lack of homogeneity among existing studies regarding the
delayed cord clamping technique create the need, in our opinion, for further research, to
establish the proper place of this measure.
Our hypothesis is that delayed cord clamping in the premature newborn significatively
reduces the need for blood transfusions and intraventricular haemorrhage, compared with
usual early cord clamping.
Secondary outcomes:
- To define the impact of delayed cord clamping on neonatal assessment parameters after
delivery: APGAR score, cord pH, need for mechanical ventilation or reanimation.
- Neonatal mortality and morbidity
- Effect of the procedure on the incidence and severity of maternal postpartum
haemorrhage
- To study the correlation between Iron metabolism and reticulocitary haemoglobin levels
in cord and infant blood.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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