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新生儿胎盘输血在140秒后达到平稳状态:体重变化纵向调查的进一步分析

Placental blood transfusion in newborn babies reaches a plateau after 140 s: Further analysis of longitudinal survey of weight change.

作者信息

Law Graham R, Cattle Brian, Farrar Diane, Scott Eleanor M, Gilthorpe Mark S

机构信息

Division of Biostatistics, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.

Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.

出版信息

SAGE Open Med. 2013 Sep 10;1:2050312113503321. doi: 10.1177/2050312113503321. eCollection 2013.

Abstract

OBJECTIVE

With the introduction of active management of the third stage of labour in the 1960s, it became usual practice to clamp and cut the umbilical cord immediately following birth. The timing of this cord clamping is controversial, as blood may beneficially be transferred to the baby if clamping of the cord is delayed slightly. There is no agreement, however, on how long the delay should be before clamping the cord. This study aimed to establish when blood ceased to flow in the umbilical cord to determine how long to delay clamping of the umbilical cord following delivery of the term newborn to maximise placental transfusion.

METHODS

This observational study collected longitudinal weight measurements set in a hospital labour ward. A total of 26 mothers at term and their singleton babies participated in the study. In this reanalysis, the velocity of weight change over the first minutes of life determined by functional data analysis was estimated.

RESULTS

We found that the flow velocity in the umbilical cord was on average 0 at 125 s after placing the baby on the scales, which was typically 140 s after birth.

CONCLUSIONS

To maximise placental transfusion, cord clamping should be delayed for at least 140 s following birth of the baby.

摘要

目的

随着20世纪60年代引入产程第三阶段的积极管理,在婴儿出生后立即夹紧并剪断脐带成为常规做法。脐带夹紧的时机存在争议,因为如果稍微延迟夹紧脐带,血液可能会有益地输送给婴儿。然而,对于在夹紧脐带之前应该延迟多长时间并没有达成共识。本研究旨在确定脐带中血液何时停止流动,以确定在足月儿出生后延迟夹紧脐带多长时间能使胎盘输血最大化。

方法

这项观察性研究收集了在医院产房进行的纵向体重测量数据。共有26名足月母亲及其单胎婴儿参与了该研究。在本次重新分析中,通过功能数据分析估算了出生后最初几分钟内体重变化的速度。

结果

我们发现,将婴儿放在秤上125秒后,脐带中的血流速度平均为0,这通常是在出生后140秒。

结论

为了使胎盘输血最大化,婴儿出生后脐带夹紧应至少延迟140秒。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e3c/4687772/1561c17c3736/10.1177_2050312113503321-fig1.jpg

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