"COMPARISON OF EARLY VS. DELAYED CORD CLAMPING ON NEONATAL OUTCOMES IN A KARACHI TERTIARY CARE HOSPITAL
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Keywords
Vaginal delivery, cesarean section, early cord clamping, delayed cord clamping, hemoglobin and bilirubin level
Abstract
Physiological studies have shown that delayed umbilical cord clamping (DCC) results in an increase of 20–40 ml of blood per kilogram of body weight for the neonate, which leads to higher hematocrits, a reduced need for red blood cell (RBC) transfusions, and a decreased frequency of iron-deficiency anemia compared to early cord clamping (ECC). However, DCC has also been associated with an increased risk of neonatal jaundice, polycythemia, and blood viscosity compared to ECC. Given these mixed outcomes, the ideal timing for umbilical cord clamping remains undetermined. This study aimed to compare the efficacy of early versus delayed cord clamping in preventing adverse neonatal outcomes at Tertiary Care Hospital, Karachi. Conducted as a randomized control trial at the Department of Obstetrics & Gynaecology Unit-2, Civil Hospital, Karachi, the study spanned six months from September 3, 2018, to March 3, 2019. Data were prospectively collected from 420 patients after obtaining consent. Demographic data were presented using simple descriptive statistics, while qualitative variables were presented as frequencies and percentages. A post-stratification chi-square test was applied, with a p-value of ≤ 0.05 considered significant. The study included 420 patients, evenly divided between the early and delayed cord clamping groups. The mean age in the groups was 31.56±3.91 and 32.71±4.01, respectively. Efficacy rates were 52.4% in the early cord clamping group and 75.2% in the delayed cord clamping group. The study concluded that delayed cord clamping is both safe and feasible, with fewer infants requiring red blood cell transfusions than those with early cord clamping. It also improves several important hematological parameters for newborns, particularly in countries with a high incidence of anemia in newborns and children.
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Taiba Khan
Health Department Govt of Sindh, Karachi, Pakistan
Sanam lashari
Health Department Govt of Sindh, Karachi, Pakistan
Safia
College of Pharmacy Liaquat University of Medical Health Sciences, Jamshoro, Pakistan
Mushfa Rehman
Health Department Govt of Sindh, Karachi, Pakistan
Sofia Lashari
NICH, Karachi, Pakistan
Daina kumari
Rims Trauma Hospital, Karachi, Pakistan
Talha Zubair
Amjad Hospital, Karachi, Pakistan