Article Text

PO-0621 Cord Pilot Trial: Cord Clamping Within 20 Seconds Versus Clamping After At Least 2 Minutes For Very Preterm Births
  1. L Duley1,
  2. A Pushpa-Rajah2,
  3. J Dorling2,3
  4. on behalf of the Cord Pilot Trial Collaborative Group
  1. 1Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
  2. 2School of Medicine, University of Nottingham, Nottingham, UK
  3. 3Cord Pilot Trial, Collaborative, Group, UK

Abstract

Background Deferring cord clamping allows blood flow between the placenta and baby to continue for a few minutes after birth; net flow is known as ‘placental transfusion’. The Cochrane Review suggests deferring cord clamping for preterm births may be beneficial.

We have developed strategies for providing initial neonatal care at the mother’s bedside with the cord intact. The Cord Pilot Trial aims to assess whether it is feasible to conduct a large randomised trial of timing of cord clamping in the UK.

Methods Women expected to have a live birth before 32 weeks are eligible. Allocation is to cord clamping either within 20 seconds or after at least 2 min (with neonatal care at the bedside). Consent is by two pathways; written consent during pregnancy, or oral assent at time of birth with written consent after birth. Follow up is until the children are age two years (corrected). The target for feasibility is to recruit 100–110 women at 8 sites over one year.

Results Overall 125 women were recruited between March 2013 and February 2014; data are available for 124. Of these, 35 (28%) were recruited via the oral assent pathway; 20 (16%) were <26 weeks gestation and 75 (60%) <30 weeks; 11 (9) were twin pregnancies; and 75 (60%) had a Caesarean section. Median time to cord clamping was 10 seconds (IQR 10–15) versus 120 (30–135). 15/134 (8.9%) babies died before discharge.

Conclusions A large multicentre trial would be feasible, implications for design and conduct will be discussed.

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