multiple births preterm infants delayed umbilical cord clamping delayed umbilical cord clamping preterm infants multiple births caesarian section
Conditions
Interventions
In the DCC group,
after each infant is delivered and placed on the mother’s perineum (in case of vaginal delivery) or on the thigh (in case of caesarian section),
the clamping and cutting of umbilical cord will be delayed for at least 30 seconds but not more than 60 seconds. During the first 30 second,
airway clearance,
drying,
suctioning,
and stimulating. In infants who response well to initial resuscitation,
the clamping and cutting of the cord will be delayed until 60 seconds. However,
in infants who do not responded to initial resuscitation or appear non-
the cord will be clamped and cut at 30 seconds or at any time during 30 to 60 seconds.,In the ICC group,
after each infant is delivered,
the umbilical cord will be clamped and cut immediately by obstetrician (less than 10 seconds).
Experimental Procedure/Surgery,Experimental Procedure/Surgery
Delayed cord clamping (DCC),Immediate cord clamping (ICC)
Sponsors
Faculty of Medicine Ramathibodi Hospital
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: Pregnant women with multiple gestations who deliver preterm infants at gestational age (GA) of 28-36 weeks’ gestation (best estimation by their earliest ultrasound or last menstrual period) is eligible to participate in the study.
Exclusion criteria
Exclusion criteria: prenatally diagnosed major congenital anomaly in any infants, twin-to-twin transfusion syndrome (TTTS) or twin anemic-polycythemic sequence (TAPS), discordant twins (weight difference of more than 20%), any intrauterine fetal death, hydrops, antepartum or intrapartum hemorrhage such as placental abruption or uterine rupture, or declination by the medical team (obstetrician or pediatrician) in performing the intervention.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Infants' hematocrit level at birth On admission after birth Central Hematocrit (%) | — |
Secondary
| Measure | Time frame |
|---|---|
| Superior Vena Cava (SVC) Flow Within 24 hours after birth Echo-cardiogram measurement,Infants' hematocrit level after birth At 8 weeks after birth Central Hematocrit (%),Other Maternal and infants' relevance clinical outcomes During hospital admission Patients' chart review | — |
Countries
Thailand
Contacts
Public ContactChayatat Ruangkit
Ramathibodi Hospital, Mahidol University
Outcome results
None listed