Study of delayed cord clamping (DCC) versus physiological cord clamping (PCC) in management of child birth
Shrinivas N Gadappa, Sonali S Deshpande, Dhanashree R Lahane
Objectives: To compare the effect of delayed cord clamping (DCC) versus physiological cord clamping (PCC) on third stage of labour and fetal outcome. Methodology: This is arandomized controlled trial. Participants were randomly assigned to control group (DCC) receiving cord clamping after 1 minute of delivery of baby and the study group (PCC) receiving cord clamping after delivery of placenta. Maternal and early neonatal outcome was analyzed and compared between the two groups by appropriate statistical test. Result: Baseline maternal characteristics were comparable in both groups. The duration of third stage of labour was higher in PCC, but no significant increase in incidence of PPH, no need of additional uterotonic and no need for blood transfusion was observed. Average FHR was normal in both the groups with FHR at 1 minute higher in PCC group and FHR at 5 minutes higher in DCC group. The fetal temperature was comparable in both groups. The mean Apgar score was higher in PCC group than DCC. Fetal haemoglobin and hematocrit values were also higher in PCC group. Conclusion: PCC is safe, effective and cost-free intervention for neonatal health benefits and should be implemented in the term and pre term infants, even in resource poor settings, where it might offer a sustainable strategy to prevent transient tachypnia of new born (TTA), hypothermia and may prevent long term anemia in new born without increasing the maternal risk of third stage complication.