placental transfusion

^[1]^[2]^[3]

Clinical significance

delaying clamping of umbilical cord (3 minutes or more rather than 10 seconds after birth) allows placental transfusion which increases to total blood volume by almost 1.3; at 4 months of age delayed clamping increases serum ferritin (117 vs 81 ug/L) & lowers prevalence of iron deficiency (0.6% vs 5.7%); blood hemoglobin levels at 4 months are unchanged by delayed clamping^[1]

delaying clamping of umbilical cord holding the infant for > 1 min at the level of the vagina
- placing the infant on the mother's chest or abdomen is as effective as holding infant at the level of the vagina^[3]

↑ ^1.0 ^1.1 Andersson O et al Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial BMJ 2011;343:bmj.d7157 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22089242 <Internet> http://www.bmj.com/content/343/bmj.d7157
van Rheenen P Delayed cord clamping and improved infant outcomes BMJ 2011;343:bmj.d7127 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22089240 <Internet> http://www.bmj.com/content/343/bmj.d7127
↑ McDonald SJ et al Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev. 2013 Jul 11;7:CD004074 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23843134 <Internet> http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004074.pub3/abstract
↑ ^3.0 ^3.1 Vain NE et al Effect of gravity on volume of placental transfusion: a multicentre, randomised, non-inferiority trial. The Lancet, Early Online Publication, 17 April 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24746755 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960197-5/abstract