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19 Late Cord-Clamping Improves Circulation in Neonates
  1. M Nelle,
  2. KN Walter,
  3. R Gerull
  1. Divison of Neonatology, University Childrens Hospital Berne, Berne, Switzerland

Abstract

Aim was to investigate the effects of late vs. early cord clamping on systemic circulation cerebral blood flow velocity (CBFV) in prematures infants < 1500g in a randomized trial.

Subjects 35 neonates were studied 4 hours after caesarean section. In 19 neonates (birth weight: 1140±240g; gestational age: 29.0±2 wks) the umbilical cords were clamped after 30 seconds and the infants were placed 30 cm below placenta level (LCC), and in 16 (1180±270g; 28.6±2 wks) the cords were clamped immediately (ECC).

Methods MBP (mmHg), left ventricular output (LVO, ml/kg/min), mean cerebral blood flow velocity (CBFV) in the Arteria carotis interna (ACI, m/s; Doppler), hemoglobin (Hb, g/dl), and hematocrit (Hct, %) were measured. Systemic and cerebral hemoglobin transport (HbT), systemic vascular resistance (SVR; mmHg/kg/min-1) were estimated. Statistic: *unpaared t-test.

Abstract 19 Table 1

Conclusions Late cord clamping improves blood pressure, systemic vascular resistance, hemoglobin, systemic and cerebral hemoglobin transport. The ECC group required more volume expansion in the first 24 h (ECC: 12/16, 14±7ml/kg; LCC: 6/19, 5±4ml/kg; p<0.03).

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