Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The purpose of this research study is to find out how delaying cutting the umbilical cord until one minute after delivery of the baby during a cesarean impacts the amount of blood the mother loses during surgery. The study will also examine the benefits to the newborn from delayed cord clamping during cesarean.
After delivery of a baby, the umbilical cord is cut to separate the baby from the placenta and the mother. The best time to cut the umbilical cord of full term babies is unknown. Traditionally, the umbilical cord is cut immediately at birth. There is however, continued blood flow from the placenta to the baby after delivery and so there may be a benefit to the baby from waiting to cut the cord until one minute after delivery. Studies show that delaying cutting the cord until at least one minute after delivery increases a full term baby's blood count in first two days of life and increases the baby's iron levels. The impact of delaying cutting the umbilical cord on a mother's health is not fully known. Delaying cutting the cord has minimal impact on the mother's health when the baby is delivered vaginally, but it is not known how delaying cutting the cord impacts the mother's health (and specifically the amount of blood a mother loses at delivery) when the baby is delivered by cesarean.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Immediate cord clamping | Other | Umbilical cord clamped within 15 seconds of delivery of baby |
|
| Delayed cord clamping | Experimental | Umbilical cord clamped 60 seconds after delivery of baby |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Umbilical cord clamping | Procedure | The umbilical cord will be clamped and cut after delivery, with timing as specified in each arm |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maternal change in hemoglobin on post-operative day #1 | Difference in hemoglobin between routine pre-op CBC and a postpartum CBC collected on postoperative day #1, by venipuncture | Baseline to postoperative day #1 (range 1-4 days) |
| Measure | Description | Time Frame |
|---|---|---|
| Postpartum hemorrhage | Incidence of postpartum hemorrhage, defined as EBL >1000cc | From day of surgery to postpartum discharge (average 3-4 days) |
| Estimated blood loss | Estimated blood loss at cesarean delivery, based on estimation provider team |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Cynthia Gyamfi-Bannerman, MD | Columbia University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Columbia University Irving Medical Center | New York | New York | 10032 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31742629 | Derived | Purisch SE, Ananth CV, Arditi B, Mauney L, Ajemian B, Heiderich A, Leone T, Gyamfi-Bannerman C. Effect of Delayed vs Immediate Umbilical Cord Clamping on Maternal Blood Loss in Term Cesarean Delivery: A Randomized Clinical Trial. JAMA. 2019 Nov 19;322(19):1869-1876. doi: 10.1001/jama.2019.15995. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D000087526 | Umbilical Cord Clamping |
| ID | Term |
|---|---|
| D036861 | Delivery, Obstetric |
| D013513 | Obstetric Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Day of surgery |
| Need for Need for additional uterotonics | Administration of uterotonics (beyond standard pitocin) during cesarean | Day of surgery |
| Maternal blood transfusion | Transfusion of blood products during or after delivery | From day of surgery to postpartum discharge (average 3-4 days) |
| Venous cord blood Hgb/Hct | Obtained from cord blood sample | Day of delivery |
| Neonatal Hgb/Hct | Obtained from neonatal heel stick | Day 0-2 of life |
| APGAR scores | Assigned at delivery | Day of delivery |
| Need for phototherapy for jaundice | Any use of phototherapy | From birth to hospital discharge (average 3-4 days) |