A new wrinkle: Umbilical cord management (how, when, who)

Semin Fetal Neonatal Med. 2018 Oct;23(5):321-326. doi: 10.1016/j.siny.2018.07.003. Epub 2018 Jul 20.

Abstract

In the past five years, umbilical cord management in both term and preterm infants has come full circle, going from the vast majority of infants receiving immediate cord clamping to virtually all governing organizations promoting placental transfusion, mainly in the form of delayed cord clamping (DCC). Placental transfusion refers to the transfer of more blood components to the infant during the first few minutes after birth. The different strategies for ensuring placental transfusion to the baby include delayed (deferred) cord clamping, milking of the attached cord before clamping, and milking of the cut cord. In this review, we address the current evidence to date for providing placental transfusion in different circumstances and the methods for implementation. We also highlight the gaps in knowledge and areas for future research.

Keywords: Cord blood; Delayed cord clamping; Immediate cord clamping; Physiologic-based cord clamping; Placental transfusion; Umbilical cord management; Umbilical cord milking.

Publication types

  • Review

MeSH terms

  • Constriction
  • Delivery, Obstetric / methods*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Placental Circulation*
  • Pregnancy
  • Umbilical Cord*