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Umbilical cord management

Key sources
The following summarized guidelines for the management of umbilical cord management are prepared by our editorial team based on guidelines from the European Consensus Group on Respiratory Distress Syndrome (ECG-RDS 2023), the American Heart Association (AHA/AAP 2023), the Society of Obstetricians and Gynaecologists of Canada (SOGC 2022), the American Heart Association (AHA 2020), the American College of Obstetricians and Gynecologists (ACOG 2020), the World Health Organization (WHO 2018), the Enhanced Recovery After Surgery Society (ERASS 2018), and the Royal College of Obstetricians and Gynaecologists (RCOG 2015).
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Guidelines

1.Medical management

Uterotonics
As per SOGC 2022 guidelines:
Administer IV uterotonic medications after clamping the cord in preterm pregnancies due to concerns about a potential bolus of blood to preterm infants.
B
Administer IV uterotonic medications with delivery of the anterior shoulder of the final infant in term pregnancies with lower risk for bolus effects of blood, lower benefits of deferred cord clamping and higher risk for maternal postpartum hemorrhage.
B
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2.Therapeutic procedures

Timing of cord clamping: as per AHA 2023 guidelines, consider delaying umbilical cord clamping (≥ 30 seconds) in preterm (< 34 weeks of gestation), late preterm (≥ 34 weeks of gestation), and term infants not requiring resuscitation.
C

More topics in this section

  • Considerations for delayed cord clamping

  • Umbilical cord milking