Delayed cord clamping Introduction - PowerPoint Presentation

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

.