Umbilical cord management strategies at cesarean section

摘要

Abstract Aim To evaluate the effect of different strategies to improve placental transfusion in cesarean section (CS). Methods Retrospective analysis of all singleton term pregnancies that underwent CS over 6?months. Delayed umbilical cord clamping (dUCC) was defined as one done at least 60?s after birth. Umbilical cord milking (UCM) was an option when waiting 60?s was deemed unsafe. The two strategies were compared against early (<60?s) umbilical cord clamping (eUCC) without milking. Neonatal hematocrit (Hct) at 48?h was the main outcome variable. Results Of the 223 CS in the cohort, 100 were performed in labor and 123 were elective. dUCC was performed in 137, eUCC without milking in 53 and UCM in 33 cases. Neonatal Hct was higher in CS carried out in labor versus in elective CS (59.76%?±?6.17 vs 56.91%?±?5.95, P = 0.001). At multivariate analysis, CS performed in labor (coefficient [coeff.] 3.44, confidence interval [CI] 1.75–5.13, P?