Neonatal Outcomes in Cord Clamping; An Observational Study Highlighting the Correlation of Cord Clamping Time with Haematological Parameters

Abstract

Objectives: The purpose of this study was to evaluate the neonatal outcomes in cord clamping and to find their correlation with different haematological parameters in neonates of Jinnah Postgraduate Medical Centre, Karachi Methodology: This was an observational study in which non-probability convenient sampling technique was used after taking ethical approval. The study was conducted on 342 pregnant women in the Obstetrics & Gynaecology ward of Jinnah Postgraduate Medical Centre, Karachi, from 1st July 2016 to 31st December 2016.All the pregnant women from age of 25 to 45 years and without any haemolytic disease, with previous spontaneous vaginal deliveries, with a singleton pregnancy diagnosed via ultrasound during the first trimester and presenting in the 3rd stage of labour with a gestational age of ≥ 37weeks were included in the study. Soon after the delivery of placenta, the uterus was massaged either by patient herself or by the caretaker. Neonatal blood samples were gathered by the researcher through venipuncture following expulsion of the fetus and 24 hours after it and sent to the pathology laboratory of Jinnah Hospital for analysis. Data were analyzed in SPSS Version 20. Descriptive analysis was done. Pearson and Spearman tests were applied to see the correlation of cord clamping time. P-value of < 0.05 was taken as significant. Results: A total of 342 pregnant females in their third stage of labor were selected for this study. No correlation existed between hemoglobin and hematocrit with cord clamping time (p-value 0.661) and (p-value 0.439) respectively. Weak positive correlation (p=0.002, r = 0.169) existed between billirubin levels with clamping time. No correlation was observed with cord clamping time and anemia, low hematocrit or polycythemia (p-value 0.422), (p-value 0.058) and (p-value 0.20) respectively while weak negative correlation (ρ = -0.221) existed between high bilirubin levels in neonates with increasing cord clamping time (p-value < 0.001). Conclusion: According to our study, no correlation exists between hemoglobin and hematocrit with cord clamping time but weak positive correlation was observed between billirubin levels with clamping time in seconds. Keywords: cord clamping; correlation; haematological parameters

Comparison of the Frequency of Neonatal Anemia in Early Versus Delayed Cord Clamping in Babies at Term

“…The amount of blood flow from placenta to fetus is termed as placental transfusion 1,2 . The estimated amount of total blood volume along with the fetal red blood cells as well as hematopoietic stem cells is 25-60 percent in fetoplacental circulation 3 .…”