quarta-feira, 19 de fevereiro de 2014

Clampeamento tardio também possível em cesariana

Já aqui tinha falado dos benefícios do clampeamento tardio do cordão umbilical após a expulsão para o feto em parto vaginal, mas agora vem a prova que também é possível em nascimentos por cesariana :)


Guideline for the management of Caesarean Section deliveries (David Hutchon) 
“The baby is delivered onto the mother’s thighs and time of delivery recorded. The baby is wrapped in the warm towel and held on the right side of the mother’s thigh about 20 cm below the height of the incision. 40 seconds after delivery the cord is clamped and cut and the baby taken for resuscitation if necessary.”
“The time of the delivery of the baby and the interval before clamping the cord must be recorded. This guideline does not apply to Crash Caesarean sections for acute fetal distress, Ceasarean sections for abruption placenta and placenta praevia or vasa praevia.”
‘Milking’ the umbilical cord at term – cesarean section“New evidence suggests immediate clamping of the umbilical cord may contribute to anemia of infancy. It can deprive a full-term infant of 25% of its blood volume, representing up to 50 mg/kg of iron. Poor iron stores can affect the developing brain. Immediate clamping is routine at cesarean section but lacks scientific evidence. Delayed clamping for two minutes can reduce anemia but is not always feasible at cesarean section.
Cord milking may offer an alternative at cesarean section for the prevention of anemia. Cord milking is easy to implement at cesarean section and may aid in the prevention of anemia in infancy. While some clinicians focus on polycythemia, a parallel concern is the incidence of anemia found in infants with immediate clamping. Cord milking appears to be an effective alternative to delayed clamping with no associated harm. More research is needed to discern causes of hyperbilirubinemia.”http://www.grin.com/en/doc/274036/milking-the-umbilical-cord-at-term-cesarean-section-effect-on-hemoglobin

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