Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Phipps 228, Baltimore, MD 228, USA.
Department of Pediatrics, Division of Neonatology, Baylor University Medical Center, Pediatrix Medical Group, Dallas, TX, USA.
Semin Perinatol. 2023 Jun;47(4):151733. doi: 10.1016/j.semperi.2023.151733. Epub 2023 Mar 17.
Placental transfusion for 30-60 s after delivery is recommended by numerous professional societies and is now a common practice. Numerous studies document neonatal benefit with minimal maternal risk when routine neonatal stabilization and active management of the third stage of labor are undertaken during the period of delayed cord clamping. Maternal outcomes do not show any increased incidence of postpartum hemorrhage, or need for blood product transfusion in the case of vaginal delivery or cesarean section. Fetomaternal hemorrhage is also likely decreased with delayed cord clamping. In the case of fetal anomalies, cord management should be individualized according to each special circumstance, but is unlikely to lead to increased maternal morbidity. While few studies have investigated maternal outcomes with umbilical cord milking, this practice has not been as widely adopted. With careful monitoring of maternal and fetal well-being, a period of placental transfusion following delivery is advised for benefit of the neonate without significant maternal risk.
胎盘输注建议在分娩后持续 30-60 秒，这一建议得到了众多专业协会的认可，目前已成为一种常见做法。大量研究证明，在延迟脐带夹闭期间，常规进行新生儿稳定处理和积极管理第三产程，可使新生儿获益，而对产妇的风险极小。在阴道分娩或剖宫产的情况下，产妇结局并未显示产后出血发生率增加，或需要输血制品。延迟脐带夹闭也可能减少胎儿-母体出血。在胎儿畸形的情况下，应根据具体情况个体化管理脐带，但不太可能导致产妇发病率增加。虽然少数研究调查了脐带挤奶对产妇结局的影响，但这种做法并未广泛采用。在仔细监测母婴健康的情况下，建议在分娩后进行一段时间的胎盘输注，以利于新生儿，而不会对产妇造成明显风险。
