The Difference of Hematocrit in Term and Preterm Vaginal Births in Different Timing of Delayed Cord Clamping

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Somprattana Mungkornkaew Theera Siwadune

Abstract

Objective :       To compare fetal hematocrit in different timing of delayed cord clamping and fetomaternal outcome at 48 hours after vaginal births

Materials and Methods :  200 term and preterm vaginal births were recruited by inclusion criteria and randomized to 1 and 2 minutes delayed cord clamping followed vaginal births. Fetal hematocrit, hemoglobin, microbilirubin were collected at 48 hours after birth. Primary outcome was the difference in fetal hematocrit among groups. Secondary outcomes were adverse fetomaternal outcomes.

Results:  200 term and preterm singleton pregnancies met the criteria; 100 cases were randomized to each groups to perform 1 minute versus 2 minutes of delayed cord clamping. Baseline characteristics were similar. Fetal blood was obtained at 48 hours after birth. Fetal hematocrit, hemoglobin and microbilirubin statistical significantly increased in 2 minutes delayed cord clamping group. (53.44% vs. 52.39 % (p = 0.041) 16.33 g/dL vs. 14.74 g/dL (p = 0.001) and 11.04 mg/dL vs. 10.17 mg/dL (p = 0.011)).  Neonatal jaundice and phototherapy requirement were higher in 2 minutes cord clamping (1% vs. 9% (p = 0.009), 1% vs. 8% (p = 0.017) and 2% vs. 10% (p = 0.017). The study showed no incidence of fetal anemia, polycythemia and exchange transfusion in both groups. No significant difference in APGAR score, maternal blood loss, postpartum hemorrhage and third stage of labor length.

Conclusion:  Significantly increased hematocrit, hemoglobin and microbilirubin in 2 minutes of cord clamping obtained at 48 hour of life. Thus, this group complicated with neonatal jaundice leads to phototherapy. 

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