In the womb the babys blood flows through the umbilical cord to and from the baby and the placenta bringing oxygen and nutrition to the baby from the mothers blood If the umbilical cord is left unclamped for a short time after the birth some of the blood from the placent ID: 642484
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Slide1
Delayed cord clampingSlide2
Introduction
In the
womb,
the baby's
blood
flows through the umbilical cord to and from the baby and the placenta bringing
oxygen
and nutrition to the baby from the mother's blood
.
If the umbilical cord is left unclamped for a short time after the birth, some of the blood from the placenta passes to the baby (this is called placental transfusion) to increase the baby's blood volume and help the flow of blood to the baby's important
organs including
the
lungs .Slide3
For many years now, standard care during the delivery of the placenta has been to clamp the cord immediately at birth.
The
umbilical cord is
physiologically
and genetically part of the fetus and, (in humans), normally contains two
arteries
(the
umbilical arteries
) and one
vein
(the
umbilical vein
), buried within
Wharton's jelly
. The umbilical vein supplies the fetus with
oxygenated
,
nutrient
-rich
blood
from the
placenta
. Conversely, the fetal heart pumps deoxygenated, nutrient-depleted blood through the umbilical arteries back to the placenta.Slide4
Clamping Of The Umbilical Cord Slide5
Delayed Cord Clamping
Umbilical cord blood is a baby’s life blood until birth
.
It contains many wonderfully precious
cells
like
, stem
cells,
RBCs and WBCs to help fight disease and infection. It makes sense that delayed cord clamping is a great option for newly born babies. Slide6
Definition of Delayed Cord Clamping
umbilical cord is not clamped or cut until after pulsations have
ceased ( 3-5 min after birth ),
or until after the placenta
is del
ivered ,Unless the mother wishes it to be cut earlier .
Any mild resuscitation of the baby can be done at the site of birth , with the benefit of continued oxygen flow to the baby through the Umbilical Cord .Slide7
Advantages of late clamping
Normal , healthy blood volume for the transition to life outside the womb (75-80 ml ).
A full count of RBCs , WBCs , stem cells & immune cells .
Improves the Iron status of the infant up to 6 month post-birth ( to one year ) .
Decrease the risk of
feto
-maternal transfusion .
In the mother , prevent complication with delivering the placenta . Slide8
Risks of delayed cord clamping
Compared
to term neonates, preterm neonates are at increased risk of temperature dysregulation, hypotension, and the need for immediate pediatric assessment and for blood
transfusion ,
The timing of delayed umbilical cord clamping ranged from 25 seconds to a maximum of 180 seconds after
delivery .
term
neonates (≥37 weeks’ gestation) have significantly lower risks of morbidity and
mortality , associated with higher neonatal hemoglobin concentration at 24 to 48 hours of life and lower likelihood of iron deficiency at 3–6 months,Slide9
Contraindication of late clamping
Placenta abruption .
Multiple gestation , specifically monochorionicgestation .
Iso-immunization & Hyropsfetalis .
Severe fetal bradycardia , or other indications for need of immediate resuscitation .
Fatal anomalies . Slide10
Relative contraindications
Multiple gestation (non-
monochorionic
)
Congenital anomalies .
Meconium amniotic fluid .Slide11
How to perform late clamping Slide12
1
Right after birth the cord is thick, pulsing. We could actually SEE it thumping with the baby’s
heartbeat . Slide13
2
There’s already a difference!! Look at how much thinner it is – less purple, less ‘tight’…Slide14
3
Less
purple ,thinnerSlide15
4
same piece of cord, same angle….now MUCH whiter, much thinner. But still not done with the transformationSlide16
5
NOW we are pretty much finished with the transformation. Compare this to the top picture of the same piece of cordSlide17
6
Completely done, Wharton’s Jelly has
liquefied,
the cord is not pulsing…it is thin, white, and very limpSlide18
‘milking’ or ‘stripping’ of umbilical cord
Milking
and stripping
; apply
to the active practice of squeezing blood down the cord to the baby
.
The
aim : shorten the time from delivery to clamping the umbilical cord while still providing up to 20 mL of placental blood.
Milking the umbilical cord is not physiologic and may provide a rapid bolus of blood to the infant .
Overall, it is not yet clear whether milking or stripping the umbilical cord is equivalent to delayed cord clamping, and further study is necessary.
Slide19
Thanks
Done By:
Sujood El-
ghouty
.
Elham
El-
ashi
. Suzan Al-hamarna . Anwar Salah .
Hend
Al-
zraiee
.
Rola
al-
masri
.
Hala
Al-
hajar
.
Nahla
kolab
.
Eman
Al-
ghalban
.