The purpose of this research study is to find out how delaying cutting the umbilical cord until one minute after delivery of the baby during a cesarean impacts the amount of blood the mother loses during surgery. The study will also examine the benefits to the newborn from delayed cord clamping during cesarean.
After delivery of a baby, the umbilical cord is cut to separate the baby from the placenta and the mother. The best time to cut the umbilical cord of full term babies is unknown. Traditionally, the umbilical cord is cut immediately at birth. There is however, continued blood flow from the placenta to the baby after delivery and so there may be a benefit to the baby from waiting to cut the cord until one minute after delivery. Studies show that delaying cutting the cord until at least one minute after delivery increases a full term baby's blood count in first two days of life and increases the baby's iron levels. The impact of delaying cutting the umbilical cord on a mother's health is not fully known. Delaying cutting the cord has minimal impact on the mother's health when the baby is delivered vaginally, but it is not known how delaying cutting the cord impacts the mother's health (and specifically the amount of blood a mother loses at delivery) when the baby is delivered by cesarean.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
113
The umbilical cord will be clamped and cut after delivery, with timing as specified in each arm
Columbia University Irving Medical Center
New York, New York, United States
Maternal change in hemoglobin on post-operative day #1
Difference in hemoglobin between routine pre-op CBC and a postpartum CBC collected on postoperative day #1, by venipuncture
Time frame: Baseline to postoperative day #1 (range 1-4 days)
Postpartum hemorrhage
Incidence of postpartum hemorrhage, defined as EBL \>1000cc
Time frame: From day of surgery to postpartum discharge (average 3-4 days)
Estimated blood loss
Estimated blood loss at cesarean delivery, based on estimation provider team
Time frame: Day of surgery
Need for Need for additional uterotonics
Administration of uterotonics (beyond standard pitocin) during cesarean
Time frame: Day of surgery
Maternal blood transfusion
Transfusion of blood products during or after delivery
Time frame: From day of surgery to postpartum discharge (average 3-4 days)
Venous cord blood Hgb/Hct
Obtained from cord blood sample
Time frame: Day of delivery
Neonatal Hgb/Hct
Obtained from neonatal heel stick
Time frame: Day 0-2 of life
APGAR scores
Assigned at delivery
Time frame: Day of delivery
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Need for phototherapy for jaundice
Any use of phototherapy
Time frame: From birth to hospital discharge (average 3-4 days)