Clinical Analysis Of Delayed Umbilical Cord Clamping In 53 Premature Infants

Objective The effect of delayed umbilical cord(DCC)on neonatal complications and intraoperative blood loss in pregnant women undergoing cesarean section for less than 37 weeks of gestation is unclear.Therefore,this study compared the 1 minute Apgar score and the 5-minute Apgar score of the newborn or immediate umbilical cord clamping(ECC)newborns,and the hemoglobin and red blood cell pressure within 24 hours after birth.The level of accumulation,the incidence of polycythemia,and the difference in the level of percutaneous bilirubin within 3 days after birth.The incidence of intraventricular hemorrhage in premature infants,the incidence of necrotizing enterocolitis,and the incidence of neonatal anemia were observed and compared within 2 weeks.The amount of blood loss during the operation of the two groups of women and the incidence of postpartum hemorrhage at 72 hours postpartum were observed.Methods Retrospective analysis was performed on the neonates who underwent cesarean section in the obstetrics department of Binzhou medical college affiliated hospital from January 2017 to December 2017.Performed delayed cord clamping ligation for more than 30 seconds during the operation.53 eligible neonates were included,and 52 neonates who were not given delayed umbilical cord amputation were included as the control group.The blood of the newborns in both groups was collected within 24 hours of birth,and was used to measure blood routine and measure serum bilirubin within 24 hours.Neonatal bilirubin levels were measured daily by skin and the results were recorded.Blood routines were reviewed within 2 weeks of birth to calculate the incidence of anemia in the newborn and the incidence of intraventricular hemorrhage.At the same time,the blood loss of the two groups of women during the operation and the incidence of postpartum hemorrhage at 72 hours postpartum were observed.The SPSS 21 software package is used for analysis and processing.Chi square test is used to compare the count data.P<0.05 showed significant difference.The frequency data is represented by percentage(%).Results(1)Comparison of maternal general conditions:There was no statistical difference in age,gestational age,and body mass index between DCC group and ECC group.(2)There was no significant difference in the 1-minute Apgar score,the 5-minute Apgar score,the intraoperative blood loss,and the neonatal weight difference between the early umbilical group and the delayed umbilical group.There was no significant difference in the 1-minute,5-minute Apgar score,intraoperative blood loss,and neonatal weight between the delayed umbilical 30-60 sec group and the delayed umbilical 61-120 sec group.(3)Delayed umbilical cord can increase hemoglobin and hematocrit in premature neonates 24,and hemoglobin and hematocrit are higher within 24 hours of delayed umbilical cord 61-120 seconds compared with delayed umbilical cord 60.The difference was statistically significant.(4)There was no significant difference in the peak value of percutaneous bilirubin between the delayed umbilical group and the early umbilical group within 3 days.(5)The incidence of anemia in neonates in the early umbilical group was 65.38%,and the incidence of anemia in the short-term group was 3.39%.The difference between the two groups was statistically significant.The incidence of neonatal anemia in the delayed umbilical 61-120 second group was lower than that in the delayed umbilical 30-60 second group,and was statistically significant.(6)The incidence of intracranial hemorrhage in premature infants in the early umbilical group was 15.38%,and the incidence of intracranial hemorrhage in premature infants in the delayed umbilical group was 3.77%,and the difference was statistically significant.(7)The incidence of neonatal respiratory distress syndrome in the early umbilical cord group was 25%,and the incidence of delayed umbilical cord group was 15.09%.The two were not statistically significant.The incidence of necrotizing enterocolitis in the early umbilical group was 17.31%,and the incidence of necrotizing enterocolitis in the delayed umbilical group was 3.77%.(8)Delaying the umbilical cord does not increase the incidence of postpartum hemorrhage.(9)Premature infants with no polycythemia were found in the early umbilical cord group or in the delayed umbilical cord group.Conclusion For single-preterm preterm women who do not have high-risk factors for postpartum hemorrhage,delayed umbilical cord during cesarean section does not significantly increase maternal bleeding and the risk of postpartum hemorrhage.Delayed umbilical cord reduction can reduce the incidence of neonatal anemia,necrotic enterocolitis,and intracranial hemorrhage in premature infants within 2 weeks.For hemoglobin and hematocrit within 24 hours,increasing the delayed umbilical cord time between 61 and 120 seconds can significantly increase the level of hemoglobin and hematocrit in preterm infants and reduce the incidence of anemia in the newborn within two weeks.Delaying the extension of the umbilical cord time does not increase the peak of transcutaneous bilirubin 3 days after birth.Therefore,delaying the umbilical cord for 60-120 seconds is safe and feasible in preterm infants with cesarean section.