Early versus delayed umbilical cord clamping in infants with congenital heart disease: a pilot, randomized, controlled trial

@article{Backes2015EarlyVD,
  title={Early versus delayed umbilical cord clamping in infants with congenital heart disease: a pilot, randomized, controlled trial},
  author={Carl H. Backes and H Huang and Clifford L. Cua and Vidu Garg and C V Smith and Han Yin and Mark Galantowicz and John Anthony Bauer and Timothy M. Hoffman},
  journal={Journal of Perinatology},
  year={2015},
  volume={35},
  pages={826-831}
}
Objective:Delayed umbilical cord clamping (DCC) at birth may provide a better neonatal health status than early umbilical cord clamping (ECC). However, the safety and feasibility of DCC in infants with congenital heart disease (CHD) have not been tested. This was a pilot, randomized, controlled trial to establish the safety and feasibility of DCC in neonates with CHD.Study Design:Pregnant women admitted >37 weeks gestational age with prenatal diagnosis of critical CHD were enrolled and… 
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References

SHOWING 1-10 OF 46 REFERENCES
Committee Opinion No.543: Timing of umbilical cord clamping after birth.
TLDR
Evidence exists to support delayed umbilical cord clamping in preterm infants, when feasible, and the possibility for a nearly 50% reduction in intraventricular hemorrhage, however, currently, evidence is insufficient to confirm or refute the potential for benefits.
Effect of Timing of Cord Clamping on Neonatal Venous Hematocrit Values and Clinical Outcome at Term: A Randomized, Controlled Trial
TLDR
Delayed cord clamping at birth increases neonatal mean venous hematocrit within a physiologic range and seems to reduce the rate of neonatal anemia.
Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes.
TLDR
There were no significant differences between early versus late cord clamping groups for the primary outcome of severe postpartum haemorrhage or for most other neonatal morbidity outcomes, such as Apgar score less than seven at five minutes or admission to the special care nursery or neonatal intensive care unit.
Immediate and Delayed Cord Clamping in Infants Born Between 24 and 32 Weeks: A Pilot Randomized Controlled Trial
TLDR
The immediate benefit of improved blood pressure was confirmed and other findings deserve consideration for further study.
The Early Effects of Delayed Cordc Clamping in Term Infants Born to Libyan Mothers
TLDR
Delaying cord clamping until the pulsations stop increases the red cell mass in term infants, and it is a safe, simple and low cost delivery procedure that should be incorporated in integrated programmes aimed at reducing iron deficiency anaemia in infants in developing countries.
Neonatal Outcome Following Cord Clamping After Onset of Spontaneous Respiration
TLDR
Clinical observations support the experimental findings of a smoother cardiovascular transition when CC is performed after initiation of ventilation, and healthy self-breathing neonates are more likely to die or be admitted if CC occurs before or immediately after onset of SR.
The Circulatory and Respiratory Adaptation to Early and Late Cord Clamping in Newborn Infants
Time of first breath and frist cry, systolic blood pressure, pulse rate and respiratory rate of 32 newborn infants whose umbilical cords were clamped early and 30 whose cords were tied late after
Effects of Leboyer childbirth on left- and right systolic time intervals in healthy term neonates
TLDR
The results suggest that Leboyer delivery was associated with transiently increased pulmonary and systemic resistance, whereas right and left ventricular functions were not affected.
Blood transfusion during versus after cardiopulmonary bypass is associated with postoperative morbidity in neonates undergoing cardiac surgery
TLDR
The results are consistent with the hypothesis that the transfusion of PRBCs during CPB may increase postoperative morbidity, however, further studies are needed to confirm a causal relationship between the timing of the transfusions and the clinical outcome and to elucidate putative mechanisms of such an association.
Blood transfusion is associated with prolonged duration of mechanical ventilation in infants undergoing reparative cardiac surgery
TLDR
In this exploratory secondary analysis of infants undergoing two ventricular repair of congenital heart disease without aortic arch obstruction, greater intraoperative and early postoperative blood transfusion emerged as potential important risk factors for longer DMV.
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