DCC -What s is new

1. Delayed
cord
clamping

2. Introduction
In the womb, the baby's blood flows
through the umbilical cord to and from the
baby and the placenta bringing oxygen and
nutrition to the baby from the mother's
blood.
 If the umbilical cord is left unclamped for a
short time after the birth, some of the blood
from the placenta passes to the baby (this is

3.  For many years now, standard care
during the delivery of the placenta has
been to clamp the cord immediately at
birth.
 The umbilical cord is
physiologically and
genetically part of the fetus
and, (in humans), normally
contains
two arteries (the umbilical

4. Clamping Of The Umbilical
Cord
Clamping of
the umbilical
cord
Early
clamping
In the first 30
sec – 3 min
Delayed
clamping
After the
pulsation is
ceased

5. Delayed Cord Clamping
• Umbilical cord blood is a
baby’s life blood until
birth.
• It contains many
wonderfully precious cells
like , stem cells, RBCs and
WBCs to help fight disease
and infection.
• It makes sense that
delayed cord clamping is a
great option for newly

6. Definition of
Delayed Cord
Clamping
umbilical cord is not clamped or cut
until after pulsations have ceased ( 3-5
min after birth ), or until after the
placenta is delivered ,Unless the
mother wishes it to be cut earlier .
Any mild resuscitation of the baby
can be done at the site of birth , with

7. Advantages of late clamping
1) Normal , healthy blood volume for the transition
to life outside the womb (75-80 ml ).
2) A full count of RBCs , WBCs , stem cells &
immune cells .
3) Improves the Iron status of the infant up to 6
month post-birth ( to one year ) .
4) Decrease the risk of feto-maternal transfusion .
5) In the mother , prevent complication with
delivering the placenta .

8. Risks of delayed cord
clamping
 Compared to term neonates, preterm neonates are at
increased risk of temperature dysregulation, hypotension,
and the need for immediate pediatric assessment and for
blood transfusion , The timing of delayed umbilical cord
clamping ranged from 25 seconds to a maximum of 180
seconds after delivery .
 term neonates (≥37 weeks’ gestation) have significantly
lower risks of morbidity and mortality , associated with
higher neonatal hemoglobin concentration at 24 to 48
hours of life and lower likelihood of iron deficiency at 3–6
months,

9. Contraindication of late clamping
 Placenta abruption .
 Multiple gestation , specifically
monochorionicgestation .
Iso-immunization & Hyropsfetalis .
Severe fetal bradycardia , or other
indications for need of immediate
resuscitation .
Fatal anomalies .

10. Relative
contraindicati
ons
‫٭‬Multiple
gestation (non-
monochorionic )
‫٭‬Congenital
anomalies .

11. How to perform late
clamping

12. 1
Right after
birth the cord
is thick,
pulsing. We
could actually
SEE it
thumping with
the baby’s

13. 2
There’s
already a
difference!!
Look at how
much thinner
it is – less
purple, less
‘tight’…

14. 3
Less
purple
,thinne
r

15. 4
same piece of
cord, same
angle….now
MUCH whiter,
much thinner.
But still not
done with the
transformation

16. 5
NOW we are
pretty much
finished with
the
transformation.
Compare this
to the top
picture of the
same piece of

17. 6
Completely
done,
Wharton’s Jelly
has liquefied,
the cord is not
pulsing…it is
thin, white,
and very limp

18. ‘milking’ or ‘stripping’ of
umbilical cord
Milking and stripping ; apply to the active practice of
squeezing blood down the cord to the baby.
The aim : shorten the time from delivery to clamping
the umbilical cord while still providing up to 20 mL of
placental blood.
Milking the umbilical cord is not physiologic and may
provide a rapid bolus of blood to the infant .
Overall, it is not yet clear whether milking or
stripping the umbilical cord is equivalent to delayed
cord clamping, and further study is necessary.

19. Thanks
Done By:
 Sujood El-ghouty .
 Elham El-ashi .
 Suzan Al-hamarna .
 Anwar Salah .
 Hend Al-zraiee .
 Rola al-masri .
 Hala Al-hajar .
 Nahla kolab .
 Eman Al-ghalban .