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Does delayed cord clamping result in higher maternal blood loss in primary cesarean sections? A retrospective comparative study

  • Fabia L. Urech EMAIL logo , Thierry Girard , Maya Brunner , Andreas Schoetzau and Olav Lapaire
Published/Copyright: April 29, 2024
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 52 Issue 5

Abstract

Objectives

The University Hospital Basel implemented delayed umbilical cord clamping of 30–60 s in all laboring women on April 1, 2020. This practice has been widely researched showing substantial benefit for the neonate. Few studies focused on maternal blood loss. The objective of our retrospective comparative study was to assess the impact of immediate vs. delayed cord clamping on maternal blood loss in primary scheduled cesarean sections.

Methods

We analyzed data of 98 women with singleton gestations undergoing primary scheduled cesarean section at term. Data from procedures with early cord clamping (ECC) were compared to those after implementation of delayed cord clamping (DCC). Primary outcomes were perioperative change in maternal hemoglobin levels, estimated and calculated blood loss. Secondary outcomes included duration of cesarean section and neonatal data.

Results

There was a statistically significant difference in the mean perioperative decline of hemoglobin of 10.4 g/L (SD=7.92) and 18.7 g/L (SD=10.4) between the ECC and DCC group, respectively (p<0.001). The estimated (482 mL in ECC vs. 566 mL in DCC (p=0.011)) and the calculated blood loss (438 mL in ECC vs. 715 mL in DCC (p=0.002)) also differed significantly. Secondary outcomes showed no significant differences.

Conclusions

In our study DCC resulted in a statistically significant higher maternal blood loss. In our opinion the widely researched neonatal benefit of DCC outweighs the risk of higher maternal blood loss in low-risk patients. However, maternal risks must be minimized, improvements to preoperative blood management and operative techniques are required.

Keywords: delayed cord clamping; maternal blood loss; early cord clamping
Corresponding author: Fabia L. Urech, Department of Obstetrics and Antenatal Care, University Hospital Basel, Basel, Switzerland, E-mail:

  1. Research ethics: The study was performed in accordance with the Declaration of Helsinki and accepted by the Ethics Committee of northern and central Switzerland (EKNZ).

  2. Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.

  3. Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2023-10-23
Accepted: 2024-02-14
Published Online: 2024-04-29
Published in Print: 2024-06-25

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Outcome of fetal congenital pulmonary malformations: a systematic review and meta-analysis
  4. Original Articles – Obstetrics
  5. Reducing decisional conflict in decisions about prenatal genetic testing: the impact of a dyadic intervention at the start of prenatal care
  6. The value of fibrinogen combined with D-dimer and neonatal weight in predicting postpartum hemorrhage in vaginal delivery
  7. Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?
  8. Does delayed cord clamping result in higher maternal blood loss in primary cesarean sections? A retrospective comparative study
  9. Trends in antenatal corticosteroid administration: did our timing improve?
  10. A national survey on current practice of ultrasound in labor ward
  11. Understanding current antenatal Hepatitis C testing and care in maternity services in England
  12. Exploring the clinical utility of exome sequencing/Mono, Duo, Trio in prenatal testing: a retrospective study in a tertiary care centre in South India
  13. Original Articles – Fetus
  14. Fetoscopic laser coagulation for twin-to-twin transfusion syndrome: a comparison of flexible 1.0/1.2 mm fetoscopes with curved sheaths of 2.7/3.3 mm2 vs. 2 mm fetoscopic lens technique with sheaths of 6.6/11.3 mm2
  15. Value of fetal echocardiographic examination in pregnancies complicated by preterm premature rupture of membranes
  16. Bias in the prenatal lung measurements in fetal congenital diaphragmatic hernia with intrauterine growth restriction
  17. Original Articles – Neonates
  18. Chest radiographic thoracic areas and respiratory outcomes in infants with anterior abdominal wall defects
  19. Temporal effects of caffeine on intrapulmonary shunt in preterm ventilated infants
  20. Letter to the Editor
  21. HDlive Silhouette features of physiological midgut herniation
https://doi.org/10.1515/jpm-2023-0450
Keywords for this article
delayed cord clamping; maternal blood loss; early cord clamping

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Outcome of fetal congenital pulmonary malformations: a systematic review and meta-analysis
  4. Original Articles – Obstetrics
  5. Reducing decisional conflict in decisions about prenatal genetic testing: the impact of a dyadic intervention at the start of prenatal care
  6. The value of fibrinogen combined with D-dimer and neonatal weight in predicting postpartum hemorrhage in vaginal delivery
  7. Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy – a balance of risks for aspirin?
  8. Does delayed cord clamping result in higher maternal blood loss in primary cesarean sections? A retrospective comparative study
  9. Trends in antenatal corticosteroid administration: did our timing improve?
  10. A national survey on current practice of ultrasound in labor ward
  11. Understanding current antenatal Hepatitis C testing and care in maternity services in England
  12. Exploring the clinical utility of exome sequencing/Mono, Duo, Trio in prenatal testing: a retrospective study in a tertiary care centre in South India
  13. Original Articles – Fetus
  14. Fetoscopic laser coagulation for twin-to-twin transfusion syndrome: a comparison of flexible 1.0/1.2 mm fetoscopes with curved sheaths of 2.7/3.3 mm2 vs. 2 mm fetoscopic lens technique with sheaths of 6.6/11.3 mm2
  15. Value of fetal echocardiographic examination in pregnancies complicated by preterm premature rupture of membranes
  16. Bias in the prenatal lung measurements in fetal congenital diaphragmatic hernia with intrauterine growth restriction
  17. Original Articles – Neonates
  18. Chest radiographic thoracic areas and respiratory outcomes in infants with anterior abdominal wall defects
  19. Temporal effects of caffeine on intrapulmonary shunt in preterm ventilated infants
  20. Letter to the Editor
  21. HDlive Silhouette features of physiological midgut herniation
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