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You are the admitting neonatal registrar. A baby delivered at 32 weeks’ gestation by caesarean section because of pregnancy induced hypertension has a haemoglobin of 17 g/dl and haematocrit (HCt) of 62. The senior house officer comments that the obstetrician had delayed clamping of the umbilical cord prior to handing the baby over “as it would be good for the baby”.
The baby is well on admission, requiring only special care and has an uneventful stay prior to hospital discharge.
Structured clinical question
Is there any evidence that in preterm babies [patient] delayed cord clamping [intervention] versus immediate cord clamping [comparison] confers benefit [outcome]?
Search strategy and outcome
The keywords “umbilical cord” and “clamp” were used. We searched for randomised control trials which looked at early (ECC) versus delayed cord clamping (DCC) in preterm babies.
PubMed (January 1993 to March 2008) and Embase databases (January 1993 to March 2008).
The Cochrane Library.
Four randomised controlled trials (RCTs) and one systematic review were identified for further appraisal. See table 1.