Delayed cord clamping in red blood cell alloimmunization: safe, effective, and free?

McAdams, Ryan M.

doi:10.21037/tp.2016.04.02

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…In a term newborn, this transfusion can consist up to one-quarter to one-third of the total neonatal blood volume [65]. In anemia secondary to erythrocyte alloimmunization, a significant increase in hemoglobulin levels at birth was observed, as well as a longer delay between birth and first transfusion, and a decrease in the number of postnatal exchange transfusions, with no notable adverse effects [66,67].…”

Section: Delayed Cord Clampingmentioning

confidence: 99%

Neonatal management and outcome in alloimmune hemolytic disease

Ree

Smits-Wintjens

Bom

et al. 2017

Expert Review of Hematology

103

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Introduction: Hemolytic disease of the fetus and newborn (HDFN) occurs when fetal and neonatal erythroid cells are destroyed by maternal erythrocyte alloantibodies, it leads to anemia and hydrops in the fetus, and hyperbilirubinemia and kernicterus in the newborn. Postnatal care consists of intensive phototherapy and exchange transfusions to treat severe hyperbilirubinemia and top-up transfusions to treat early and late anemia. Other postnatal complications have been reported such as thrombocytopenia, iron overload and cholestasis requiring specific management. Areas covered: This review focusses on the current neonatal management and outcome of hemolytic disease and discusses postnatal treatment options as well as literature on long-term neurodevelopmental outcome. Expert commentary: Despite major advances in neonatal management, multiple issues have to be addressed to optimize postnatal management and completely eradicate kernicterus. Except for strict adherence to guidelines, improvement could be achieved by clarifying the epidemiology and pathophysiology of HDFN. Several pharmacotherapeutic agents should be further researched as alternative treatment options in hyperbilirubinemia, including immunoglobulins, albumin, phenobarbital, metalloporphyrins, zinc, clofibrate and prebiotics. Larger trials are warranted to evaluate EPO, folate and vitamin E in neonates. Long-term follow-up studies are needed in HDFN, especially on thrombocytopenia, iron overload and cholestasis.ARTICLE HISTORY

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Section: Delayed Cord Clampingmentioning

confidence: 99%

Neonatal management and outcome in alloimmune hemolytic disease

Ree

Smits-Wintjens

Bom

et al. 2017

Expert Review of Hematology

103

View full text Add to dashboard Cite

show abstract

“…19 DCC is said to cause neonatal hyperbilirubinemia and increase the need for phototherapy. 1,11,20 In the study conducted by Carvalho et al 54.4% neonates required phototherapy, and concluded that clamping time of the umbilical cord showed no association with jaundice, bilirubin dosage, or phototherapy needs in neonates at normal risk. 13 In the study conducted by Qian et al 18.8% neonates required phototherapy.…”

Section: Discussionmentioning

confidence: 97%

A prospective study of effect of delayed cord clamping in term babies as well as in preterm babies

Priya

Biswas

Rani

2023

Int J Reprod Contracept Obstet Gynecol

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Background: Delayed cord clamping (DCC) is lengthening the time between delivery of newborn and the clamping of their umbilical cord. It is usually performed 25 seconds to 5 minutes after birth, which increases the newborn’s iron storage, vital for healthy brain development. Methods: This prospective observational study was conducted on 100 late preterm and term newborns delivered in the obstetrics and gynaecology department of Calcutta national medical college and hospital, Kolkata over a period of one and half years (March 2019 to August 2020). The umbilical cord was clamped between 60 to 90 seconds after birth of baby. Babies’ weight measurement and blood investigations (Haemoglobin (Hb) level, total serum bilirubin (TSB) and serum ferritin) were performed at birth, after 24 hours of birth and at 6 weeks of age. Results: In this study after DCC, there is significant increase in Serum Ferritin levels after 24 hours and 6 weeks as compared to the birth values. As far as the values of TSB and hemoglobin is concerned, the values first showed increment after 24 hours and then decreased at 6 weeks, which is statistically significant (p=0.001). Birth weight which first decreased after 24 hours, increased at 6 weeks. None of the babies needed blood transfusion during the study period. Out of 100 cases, 9 were admitted in NICU and required phototherapy which was not directly associated with umbilical cord clamping time or bilirubin values at birth. Conclusions: Based on the results of this study, we conclude that newborns with DCC had statistically significant higher levels of Hb and ferritin after birth. This may ensure better iron status throughout infancy along with reduced need of blood transfusion and its related adversities. Delaying cord clamping seems to be beneficial in late preterm and term neonates without causing additional morbidities in the first 6 weeks of life.

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“…This procedure decreases the circulating bilirubin level by replacing antibodycoated RBCs with antigen-negative RBCs (71). Exchange transfusion should also be undertaken immediately when the neonate shows signs of acute bilirubin and encephalopathy, including hypertonia, arching, retrocollis, opisthotonos and high pitch crying (3).…”

Section: Clinical Managementmentioning

confidence: 99%

Haemolytic of Newborn Disease-Related Red Blood Cell Alloantibodies

Nahendran

Budin²,

Saat³

et al. 2022

Jurnal Teknologi

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Red cell alloimmunisation in pregnancy may result in haemolytic disease of the foetus and newborn (HDN). During pregnancy, there are possibilities of the foetal antigen being exposed to the mother’s circulation, thereby leading to the production of antibodies. The immunoglobulin G (IgG) antibodies from the mother pass through the maternal surface placenta, which is then sensitised and obstructs the formation of foetal red blood cells (RBCs). This review discusses the presence of variance alloantibodies during pregnancy, as well as the consequences of HDN and its management. This review revealed that ABO incompatibility is the most common cause of alloimmunisation in pregnancy. The Rh system (anti-D and -E) are the most common alloantibodies found in pregnant women, followed by other alloantibodies such as Kell, Duffy, Kidd and MNSs. Hyperbilirunemia (increased bilirubin levels) is commonly seen in neonatal jaundice due to HDN and it is usually manageable using the phototherapy method. Nevertheless, the clinical significance of alloantibodies can cause complications such as anaemia, and in some extreme cases, kernicterus might require a blood exchange transfusion.

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Delayed cord clamping in red blood cell alloimmunization: safe, effective, and free?

Cited by 6 publications

References 27 publications

Neonatal management and outcome in alloimmune hemolytic disease

Neonatal management and outcome in alloimmune hemolytic disease

A prospective study of effect of delayed cord clamping in term babies as well as in preterm babies

Haemolytic of Newborn Disease-Related Red Blood Cell Alloantibodies

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