|Concerns about umbilical cord clamping
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an urgent ongoing need
fetal to postnatal circulation
>>Concerns (NCS p5)
Contact: Eileen Nicole Simon
|"After waiting until the pulsation in the exposed umbilical cord has ceased, the child is severed
from its mother." – Greenhill 1951, p 251 .
|" The cord is cut after about three minutes or after it collapses." – Greenhill 1955, pp280-282 .
|"After pulsation in the exposed cord has ceased, using dull scissors, the child is separated from
its mother." – Greenhill 1965, p 376 
|"The cord is clamped and divided as soon as pulsations have ceased." – Garrey et al.
1974, p359 
|"The umbilical cord should be tied up after its vessels stop pulsating, which occurs in 2-3
min following the delivery of the infant." – Bodyazhina 1983, p 156 .
|"Q: What is the significance of continued pulsation of the arteries in the umbilical cord at
|A: It means that respiration has not commenced. The physiological stimulus causing
closure of umbilical arteries (and ductus arteriosus) is an increase in oxygen saturation of
the blood which occurs when the lungs expand with air." – Beischer et al. 1986, p 710 .
|4. Recent change of opinion
Reasons for clamping the cord early were stated in many of the above textbooks. Cord
around the neck occurs in about one out of every four births, and though efforts to
loosen the loop are usually encouraged, often the advice was to clamp the cord to
hasten delivery. Eastman, editor of the tenth edition of William's Obstetrics in 1950 cited
other factors such as apnea from anesthesia, quick repair of the episiotomy, and
management of the third stage of labor:
|"Whenever possible, clamping or ligating the umbilical cord should be deferred until its
pulsations wane or, at least, for one or two minutes.
|Posted: February 27, 2006
(a work in progress)
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