Waiting for cord to stop pulsating before clamped & cut

Specialties Ob/Gyn

Published

Hi, I was just wondering... I keep reading about waiting for the cord to stop pulsating before it is clamped & cut and how this is a good thing. I never saw this being done in my rotation (I didn't think it was a big deal) and haven't found a reason why it's done. I figure it is done to allow the baby to receive more blood from the placenta.

But what is the reason... nutrients, O2, or d/t babies losing blood from draws that may be done later?

It seems like it is only done if mom requests it. Do many pt.s ask for this?

Specializes in cardiac, diabetes, OB/GYN.

What Butty Baby Grower? No one here said everytime is a problem...

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Specializes in NICU, PICU, educator.

Neither did I, but according to this docs stats, for every newborn or preemie that is clamped early he/she should by all means be oxygen deprived. He also stated that if you leave the cord, you can "cure" RDS, which we all know you can't without surfactant. We are also seeing a climb in the autistic, Aspergers, etc because we are more in tune with these kids...before they were just labeled difficult. I agree with Fergus, correlation and causation aren't one in the same.

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Specializes in cardiac, diabetes, OB/GYN.

I agree with that as well...We should just be hyperaware in those cases that potentially warrent it, and be grateful when bad things don't occur...

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Clamping the cord after it stops pulsing sounds good and seems very romantic however, there are no benefits to it.

I watched a show recently where a mass had to be romoved from baby before he was born all the way. They delivered the head and chest(via c-section), removed the mass, stiched baby's chest, and then removed baby and clamped and cut cord. They said as long as the cord wasn't cut, it would still provide baby with O2. The mass was taking up so much of his chest cavity that his lungs would not have been able to expand.

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Specializes in private duty/home health, med/surg.
Clamping the cord after it stops pulsing sounds good and seems very romantic however, there are no benefits to it.

I watched a show recently where a mass had to be romoved from baby before he was born all the way. They delivered the head and chest(via c-section), removed the mass, stiched baby's chest, and then removed baby and clamped and cut cord. They said as long as the cord wasn't cut, it would still provide baby with O2. The mass was taking up so much of his chest cavity that his lungs would not have been able to expand.

That sounds like an extremely rare case, imrichmom4. I hope the baby & mom were okay. I would imagine that any baby who was only partially born would have difficulty getting the lungs to expand fully & would therefore still need the cord attached, which is why the cord is cut after the entire body is born.

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That sounds like an extremely rare case, imrichmom4. I hope the baby & mom were okay. I would imagine that any baby who was only partially born would have difficulty getting the lungs to expand fully & would therefore still need the cord attached, which is why the cord is cut after the entire body is born.

That should be proof that the cord is still providing O2 thought right? We chose to delay with our home births but my placenta's came out within 10 minutes of birth. I'm not sure I'd leave it uncut for too long. Mine is just an informed opinion, surely not a professional opinion. I think in my situation where baby was placed up high on my chest and placenta was birthed about 10 minutes after birth, it was OK(maybe beneficial) to leave the cord uncut until it stopped pulsating. In the baby with the lung mass, the surgery was done using partial birth because his lungs would not have expanded had he been fully born. They had to get the mass out while he was left on some sort of life support(uncut cord).

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Specializes in NICU.

Let me get this straight. If you don't clamp and cut the cord, and keep the baby at the same level as mom, there should not be a problem. If you lift the baby on to mom's abdomen/chest, there is a potential for feto/maternal transfusion, and baby could have a low crit. (that would be really dumb). If you lower the baby it would get too much blood and become plethoric.

I can't imagine that the family are going to be careful and think about these potentials, while they are cooing over the new baby, and mom wants to hold it!

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Let me get this straight. If you don't clamp and cut the cord, and keep the baby at the same level as mom, there should not be a problem. If you lift the baby on to mom's abdomen/chest, there is a potential for feto/maternal transfusion, and baby could have a low crit. (that would be really dumb). If you lower the baby it would get too much blood and become plethoric.

I can't imagine that the family are going to be careful and think about these potentials, while they are cooing over the new baby, and mom wants to hold it!

I'm not going to argue this one out. I'm just offering a differnt point of veiw. Of all the home births I've heard about cord clamping was delayed. To me it doesn't matter one way or the other. I could have cared less when the cords were cut. But of my 4 kids, 2 were delayed and two weren't. All were just as healthy as the other. All 4 had jaundice. If they aren't supposed to be up high maybe he wasn't. I know he wasn't lower. I don't know. I just think that they must be getting O2 still while the cord is unclamped. I don't think this is one of the greater issues in child birth. I would speak up for other "procedures" before this one.

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Feto-maternal transfusions are serious and need to be avoided! Take it from me, I've seen one case in my career and it was nasty. I have never seen a baby that was so white. It's important to consider this if parents choose to have the cord clamping delayed.

As far as baby getting O2 or not from the cord, it really doesn't matter if they are capable of breathing on their own. If they can breathe on their own, they get the O2 that they need and don't need "extra" from the placenta. This is the same reason we put babies onto mom's chests instead of taking them away to give them blow by O2 on a warmer like they used to in the olden days:) (it isn't necessary to give supplemental oxygen to infants who are breathing well on their own). Certain cases like the one imrichmom4 described are exceptions and very important, but IMO the majority of delayed cord clamping is done based on preferences not needs and are not based on any good studies simply because there aren't any good studies yet. I think preferences of parents should be respected as long as they can be done safely and hopefully some good studies will be done in the future to answer this question.

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Specializes in NICU, PICU, educator.

I'm also sure that they gave the mom enough meds that baby wasn't moving a whole lot if at all so that they could get to the mass...they would have given pain meds and most likely some sort of short acting paralytic to the baby. I'm sure that they didn't want the baby to cry at all. If they didn't, well, can we say butcher? So they needed the cord to provide the O2. They do surgeries with the baby's still in utero...diaphragmatic hernias, spina bifidas. So, the mom is used as a ventilator in those situations too :)

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