BMJ  2006;333:1073 (18 November), doi:10.1136/bmj.39030.733715.3A

Letters

Delayed cord clamping may also be beneficial in rich settings

The first 150 words of the full text of this article appear below.

Delayed cord clamping reduces infant anaemia in resource poor settings.¹ There are, however, other implications, and neonatal anaemia is still important in developed countries. In Darlington we have a guideline to delay cord clamping for at least 40 seconds.²

It was a pragmatic decision to make 40 seconds the interval, and the rather longer time as suggested by van Rheenen and Brabin is likely to be closer to the physiological interval. We have also developed a method of resuscitation of the neonate at caesarean section with the cord intact .Although this method has not been included in the guideline there are plans to do so.

Fetal distress is a common reason for instrumental delivery or caesarean section. The fetal compromise is often due to cord compression associated with a nuchal cord. A nuchal cord results in compression of the low pressure venous return of oxygenated blood from the placenta. Blood . . . [Full text of this article]

¹ Memorial Hospital, Darlington DL3 8QZ DJRHutchon@Postmaster.co.uk

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A practical approach to timing cord clamping in resource poor settings

Patrick F van Rheenen and Bernard J Brabin
BMJ 2006 333: 954-958. [Extract] [Full Text] [PDF]