LETTERS
The optimal time to clamp the umbilical cord
Accepted 5 March 2007
| The first 150 words of the full text of this article appear below. |
"No consensus exists about the optimal time to clamp the umbilical cord."
Dr Ultee and coworkers in this issue of Heart link immediate cord clamping (ICC) to childhood mental retardation (MR) (see page F20).1
The study shows that ICC generates more anaemia than delayed cord clamping (DCC)—by removing more blood volume than removed by DCC. The amount of placental transfusion determines a neonate’s blood volume. ICC causes "hypotension, hypovolaemia and infant anaemia",2 resulting in "cognitive deficits." At what time will DCC prevent these injuries?
Physiological placental transfusion is generated by gravity or by uterine contraction, or by both, is regulated by the child’s reflexes, and is terminated by reflexive closure of the umbilical vessels when the child has attained a maximal, optimal blood volume.3 Physiological placental transfusion provides enough iron to prevent infant anaemia during the first year of life.4
This study (and all others on cord clamping)
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Arch. Dis. Child. Fetal Neonatal Ed. 2008 93: F1.[Extract] [Full Text] [PDF]
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