Perrone Barbara, Ghirardello Stefano
Division of Neonatology and Neonatal Intensive Care Unit, "G. Salesi" Children's Hospital, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Ancona, Italy.
Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano, Italy.
Am J Perinatol. 2017 Jun;34(7):722-728. doi: 10.1055/s-0036-1597995. Epub 2017 Jan 6.
Delayed umbilical cord clamping and cord milking are placental transfusion strategies that produce higher iron stores and better hemodynamic conditions in a newborn. We aimed to evaluate their current practice in tertiary-care delivery wards in Italy. A multiple-choice questionnaire was e-mailed to all the 101 Italian tertiary-care delivery wards. The comparative analysis between categorical variables was performed by the χ test. We obtained an 85% (86/101) response rate. Where placental transfusion strategies were applied, in 61% of cases they were performed in less than half of deliveries. Obstetric-neonatal guidelines were available in 21% of the centers. Where they were available, application of delayed clamping and milking was significantly more frequent and clamping time was longer. This first Italian nationwide survey on placental transfusion strategies showed low application rate and variability in knowledge and execution. Availability of obstetric-neonatal guidelines, knowledge of benefits, and cooperation within the delivery team were associated with enhanced implementation.
延迟脐带结扎和脐带挤血是胎盘输血策略，可使新生儿获得更高的铁储备和更好的血流动力学状况。我们旨在评估意大利三级医疗分娩病房中这些策略的当前应用情况。向意大利所有101家三级医疗分娩病房发送了一份多项选择题问卷。分类变量之间的比较分析采用χ检验。我们获得了85%（86/101）的回复率。在采用胎盘输血策略的情况下，61%的病例是在不到一半的分娩中实施的。21%的中心有产科-新生儿指南。在有指南的地方，延迟结扎和挤血的应用明显更频繁，结扎时间更长。这项首次针对意大利全国胎盘输血策略的调查显示，其应用率较低，在知识和执行方面存在差异。产科-新生儿指南的可用性、对益处的了解以及分娩团队内部的合作与实施的加强有关。
