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placental transfusion
Procedure:
- delaying clamping of umbilical cord holding the infant for > 1 min at the level of the vagina
- placing the infant on the mother's chest or abdomen is as effective as holding infant at the level of the vagina [3]
Clinical significance:
- delaying clamping of umbilical cord (3 minutes or more rather than 10 seconds after birth) allows placental transfusion which increases to total blood volume by almost 1.3; at 4 months of age delayed clamping increases serum ferritin (117 vs 81 ug/L) & lowers prevalence of iron deficiency (0.6% vs 5.7%); blood hemoglobin levels at 4 months are unchanged by delayed clamping [1]
Complications:
- need for phototherapy for hyperbilirubinemia is more common with placental transfusion
General
blood transfusion
References
- Andersson O et al
Effect of delayed versus early umbilical cord clamping on
neonatal outcomes and iron status at 4 months: a randomised
controlled trial
BMJ 2011;343:bmj.d7157
PMID: 22089242
http://www.bmj.com/content/343/bmj.d7157
- van Rheenen P
Delayed cord clamping and improved infant outcomes
BMJ 2011;343:bmj.d7127
PMID: 22089240
http://www.bmj.com/content/343/bmj.d7127
- McDonald SJ et al
Effect of timing of umbilical cord clamping of term infants on
maternal and neonatal outcomes.
Cochrane Database Syst Rev. 2013 Jul 11;7:CD004074
PMID: 23843134
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004074.pub3/abstract
- Vain NE et al
Effect of gravity on volume of placental transfusion: a
multicentre, randomised, non-inferiority trial.
The Lancet, Early Online Publication, 17 April 2014
PMID: 24746755
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960197-5/abstract