Timing of umbilical cord clamping among infants with congenital heart disease
| Autor: | Clifford L. Cua, Laura Marzec, Sara K. Pasquali, Anup Katheria, Carl H. Backes, Eli T. Zettler, Brian K. Rivera |
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| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Heart disease Population Systematic review methodology 030204 cardiovascular system & hematology Umbilical cord Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law 030225 pediatrics Medicine education education.field_of_study business.industry Potential risk medicine.disease medicine.anatomical_structure Pediatrics Perinatology and Child Health Gestation Cardiology and Cardiovascular Medicine business Umbilical cord clamping |
| Zdroj: | Prog Pediatr Cardiol |
| ISSN: | 1058-9813 |
| Popis: | The optimal timing of clamping and cutting the umbilical cord at birth among infants with congenital heart disease (CHD) remains a subject of controversy and debate. The benefits of delayed umbilical cord clamping (DCC) among term infants without CHD are well described, but the evidence base for DCC among infants with CHD has not been characterized adequately. The goals of the present review are to: 1) compare outcomes of DCC versus early cord clamping (ECC) in term (≥37 weeks of gestation) infants; 2) discuss potential risk/benefit profiles in applying DCC among term infants with CHD; 3) use rigorous systematic review methodology to assess the quality and quantity of published reports on cord clamping practices among term infants with CHD; 4) identify needs and opportunities for future research and interdisciplinary collaboration. Our systematic review shows that previous trials have largely excluded infants with CHD. Therefore, the supposition that DCC is advantageous because it is associated with improved neurologic and hematologic outcome is untested in the CHD population. Given that CHD is markedly heterogeneous, to minimize unnecessary and potentially harmful cord clamping practices, identification of subgroups (single-ventricle, cyanotic lesions) most likely to benefit from optimal cord clamping practices is necessary to optimize risk/benefit profiles. The available evidence base suggests that contemporary, pragmatic, randomized controlled trials comparing DCC with ECC among infants with CHD are needed. |
| Databáze: | OpenAIRE |
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