Active management of the third stage of labour: Prevention and treatment of postpartum hemorrhage

Leduc, Dean; Senikas, Vyta; Lalonde, André B.; Ballerman, Charlotte; Biringer, Anne; Delaney, Martina; Duperron, Louise; Girard, Isabelle; Jones, Donna; Lee, Lily Shek-Yun; Shepherd, Debra; Wilson, Kathleen

doi:10.1016/j.ijgo.2009.11.002

Cited by 25 publications

(6 citation statements)

References 41 publications

(61 reference statements)

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“…When categorizing the given time points into ECC and DCC according to the most common definition used in international guidelines (ECC: <1 min and DCC: late >1 min and/or pulsations cease and/or placental detachment [21,22,24,26,27,30,31]), 90% of caregivers practised DCC, 6% practised ECC and 4% gave no specified time point. In uncomplicated births, midwives used DCC more often than obstetricians (97 vs. 75%, p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…When categorizing this into ECC and DCC [21,22,24,26,27,30,31], ECC was practised by 36% (24/66), DCC by 54% (36/66) and the time point could not be defined in 10% (6/66).…”

Section: Resultsmentioning

confidence: 99%

“…This dogmatic approach warrants more studies on what actually happens with the venous and arterial flow before the cord is clamped. In the most recent guidelines [4,20,21,22,23,24,25,26,27,28,29,30,31], it was not the cessation of pulsations but variable time points that were given, ranging from 30 s to 3 min after birth (online suppl. table).…”

Section: Discussionmentioning

confidence: 99%

“…Other guidelines recommend delaying CC for at least between 30 and 60 s [24,28,29,45], at least 1 min [21,22,26,27,46] or to wait for 1-3 min [23,30]. The international guidelines recommend 1 of 3 time points depending on the results of different studies that compare ECC with DCC.…”

Section: Discussionmentioning

confidence: 99%

“…table; for all online suppl. material, see www.karger.com/doi/10.1159/000365836) [4,20,21,22,23,24,25,26,27,28,29,30,31]. Although the available guidelines for uncompromised, term infants are conflicting [21,24,29,30], a recent meta-analysis reviewing all studies comparing ECC with DCC concluded that DCC is recommended in preterm births [32].…”

Section: Introductionmentioning

confidence: 99%

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Current Practice of Cord Clamping in The Netherlands: A Questionnaire Study

Boere¹,

Smit²,

Roest³

et al. 2014

Neonatology

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Background: Recent meta-analyses recommend delayed cord clamping (DCC) after uncomplicated births as well as preterm births, but there is no clear definition of timing and uniform national guidelines are lacking. Objective: We aimed to investigate if guidelines for the timing of cord clamping (CC) are followed and what the national practice entails. Methods: A postal questionnaire concerning CC after uncomplicated vaginal, Caesarean term and preterm deliveries was sent to all midwifery practices (n = 526) and obstetrical departments (n = 94) in the Netherlands. Results: The response rate was 81% (500/620). CC protocols were present in 16 and 38% of midwifery and obstetric practices, respectively. Early cord clamping (ECC) was recommended in 54%, DCC in 33%, 6% indicated a specific time point and 7% did not specify. In current practice, DCC was applied after uncomplicated vaginal term deliveries in 90% and ECC in 6%, and no timing was specified in 4%. Midwives used DCC more often than obstetricians (97 vs. 75%). Cessation of cord pulsations was often (54%) used as a time point, 40% used a fixed time point, 2% waited for placental expulsion and 4% did not specify. ECC was preferred in obstetric practices after Caesarean deliveries (in 81%). In preterm births, ECC was practised by 36%, DCC by 54 and 10% did not specify. Conclusion: In the Netherlands, although often not protocolized, DCC is widely used after uncomplicated vaginal term and preterm deliveries, but not after Caesareans. Cessation of cord pulsation is often used as the time point for CC.

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Section: Resultsmentioning

confidence: 99%

“…When categorizing this into ECC and DCC [21,22,24,26,27,30,31], ECC was practised by 36% (24/66), DCC by 54% (36/66) and the time point could not be defined in 10% (6/66).…”

Section: Resultsmentioning

confidence: 99%