Levy Tali, Blickstein Isaac
Hadassah-Hebrew School of Medicine, Jerusalem, Israel.
J Perinat Med. 2006;34(4):293-7. doi: 10.1515/JPM.2006.056.
Although cord cutting has been performed since the beginning of mankind, the timing and advantages of early versus delayed cord clamping are still controversial. Early cord clamping (within the first 30 s after birth) is usually justified for potential prevention of postpartum hemorrhage and for immediate treatment of the newborn, but at the same time, may increase Rh-sensitization. Delayed cord clamping is performed after a period of 30 s during which 'placental transfusion' of approximately 80 mL of blood occurs. This amount seems to protect the baby from childhood anemia without increasing hypervolemia-related risks. In preterm infants, delayed clamping appears to reduce the risk of intraventricular hemorrhage and the need for neonatal transfusion. Obtaining cord blood for future autologous transplantation of stem cells needs early clamping and seems to conflict with the infant's best interest. Although a tailored approach is required in the case of cord clamping, the balance of available data suggests that delayed cord clamping should be the method of choice.
尽管自人类诞生之初就已进行脐带结扎，但早期与延迟脐带结扎的时机及优势仍存在争议。早期脐带结扎（出生后30秒内）通常因可能预防产后出血及便于立即治疗新生儿而被视为合理，但与此同时，可能会增加Rh致敏的风险。延迟脐带结扎是在出生后30秒后进行，在此期间会发生约80毫升血液的“胎盘输血”。这个血量似乎能保护婴儿免受儿童期贫血的影响，同时又不会增加与血容量过多相关的风险。对于早产儿，延迟结扎似乎能降低脑室内出血的风险以及新生儿输血的必要性。获取脐带血用于未来的自体干细胞移植需要早期结扎，这似乎与婴儿的最大利益相冲突。尽管在脐带结扎问题上需要采取个性化方法，但现有数据的权衡表明，延迟脐带结扎应是首选方法。
