Conflict of interest The authors have stated explicitly that there are no conflicts of interest in connection with this article.
MAIN RESEARCH ARTICLE
Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial
Article first published online: 17 OCT 2012
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Volume 92, Issue 5, pages 567–574, May 2013
How to Cite
Andersson, O., Hellström-Westas, L., Andersson, D., Clausen, J. and Domellöf, M. (2013), Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial. Acta Obstetricia et Gynecologica Scandinavica, 92: 567–574. doi: 10.1111/j.1600-0412.2012.01530.x
Please cite this article as: Andersson O, Hellström-Westas L, Andersson D, Clausen J, Domellöf M. Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial. Acta Obstet Gynecol Scand. 2013;92:567–574.
- Issue published online: 17 APR 2013
- Article first published online: 17 OCT 2012
- Accepted manuscript online: 22 AUG 2012 04:55PM EST
- Received: 15 February 2012 Accepted: 14 August 2012
- active management;
- delayed clamping;
- blood gases;
- term birth;
- umbilical cord;
- postpartum hemorrhage;
- third stage of labor
Objective. To investigate the effect of delayed cord clamping (DCC) compared with early cord clamping (ECC) on maternal postpartum hemorrhage (PPH) and umbilical cord blood gas sampling. Design. Secondary analysis of a parallel-group, single-center, randomized controlled trial. Setting. Swedish county hospital. Population. 382 term deliveries after a low-risk pregnancy. Methods. Deliveries were randomized to DCC (≥180 seconds, n = 193) or ECC (≤10 seconds, n = 189). Maternal blood loss was estimated by the midwife. Samples for blood gas analysis were taken from one umbilical artery and the umbilical vein, from the pulsating unclamped cord in the DCC group and from the double-clamped cord in the ECC group. Samples were classified as valid when the arterial–venous difference was −0.02 or less for pH and 0.5 kPa or more for pCO2. Main outcome measures. PPH and proportion of valid blood gas samples. Results. The differences between the DCC and ECC groups with regard to PPH (1.2%, p = 0.8) and severe PPH (−2.7%, p = 0.3) were small and non-significant. The proportion of valid blood gas samples was similar between the DCC (67%, n = 130) and ECC (74%, n = 139) groups, with 6% (95% confidence interval: −4%−16%, p = 0.2) fewer valid samples after DCC. Conclusions. Delayed cord clamping, compared with early, did not have a significant effect on maternal postpartum hemorrhage or on the proportion of valid blood gas samples. We conclude that delayed cord clamping is a feasible method from an obstetric perspective.