DELAYED UMBILICAL-CORD CLAMPING IN PRETERM INFANTS - A FEASIBILITY STUDY

Objectives: To assess: (i) the size of placental transfusion following a 30 s delay in cord clamping following vaginal and Caesarean births; and (ii) the feasibility of delaying cord clamping in the labour ward and particularly in the operating theatre. Methods: Fourty-six infant s born at 26-33 weeks gestation were randomized to having the umbilica l cord clamped either immediately or 30 s after birth. The venous haem atocrit was measured at 1 and at 4 h of age. Results: There were trend s towards higher mean haematocrits in the infants following delayed cl amping, but these were not significant either at 1 h (55 +/- 7.7 vs 52 .9+/-7) or at 4 h of age (55+/-7 vs 52.5+/-7). The trends were more ma rked in the infants born by Caesarean section, and in those born at 26 -29 weeks gestation. Conclusions: A 30 s delay in cord clamping is fea sible at both vaginal and Caesarean births, but does not lead to the p redicted difference in infant haematocrit. Although physiological stud ies suggest that a placental transfusion of 15-20 mL/kg occurs within 30s of delivery, these data suggest that future trials should either d elay cord clamping for more than 30 s, or should alter the position of the infant in relation to the uterus in order to facilitate the trans fusion. Delayed cord clamping is feasible at Caesarean section.