INTRODUCTION One of the peculiarities of the umbilical cord is its pulsatility, detectable by palpation, which has often been used to define the optimal timing for cord clamping. Despite being widely used, the exact duration of umbilical cord pulsatility and the possible variables that could significantly affected it are unknown. The primary outcome was the duration of umbilical cord pulsatility, defined as the period in seconds between birth and the end of spontaneous pulsation of the cord. The secondary outcome was the possible association between the duration of pulsatility with maternal, obstetric and neonatal variables. METHODS This is an observational study on women admitted to a tertiary care hospital between February and September 2016. Women with a singleton pregnancy at term who had a spontaneous vaginal delivery and cord clumping at the cessation of pulsations were included in the study. Exclusion criteria were the following: multiple gestation, gestational age at delivery < 37 weeks, cesarean delivery, umbilical cord milking. The collection of pulsatility duration was performed by the same operator through a stopwatch and by manual palpation of the umbilical cord. Based on the average time of pulsatility, the population was divided into two groups: a group with an increased cord pulsatility duration (long-term pulsatility group) and a group with a reduced cord pulsatility duration (short-term pulsatitlity group). The two groups were compared for maternal variables (maternal age, BMI, parity and hemoglobin antepartum), obstetric variables (gestational diseases, the gestational age at delivery, the induction of labor rate, the duration of the first and the second stage of labor, the post-partum blood loss and the umbilical cord length) and neonatal variables (birthweight, cord blood pH, Apgar score, hematocrit and hemoglobin values). Statistical analysis was performed with the Student’s t-tests, Mann-Whitney test and KruskallWallis test for continuous variables and Pearson’s test and Fisher exact test for categorical variables where appropriate. SPSS® version 23 (SPSS Inc, Chicago, IL) was used for statistical analysis and a p-value < 0.05 was considered significant. RESULTS A total of 102 women with a spontaneous vaginal delivery at term were identified. The mean duration of umbilical cord pulsatility after birth was 308.6 ± 244.8 seconds with a range of 39-1,200 seconds. The long-term pulsatility group had similar maternal clinical characteristics compared with the shortterm pulsatility group. The obstetrics variables were similar in both groups. The infants in the longterm pulsatility group had a significantly higher birth weight (3,457.8 ± 392.6 vs 3,279 ± 389.7) and a significantly lower cord blood pH (7.05 vs 7.27) compared with the infants in the shortterm pulsatility group. No differences in the other neonatal outcomes were found. CONCLUSIONS The duration of umbilical cord pulsatility after a vaginal delivery in women with a singleton pregnancy at term was established. The timing of the cord pulsatility may be affected by the birth weight and the cord blood pH but additional studies are necessary to clarify this issue and to identify the potential determinants of the duration of umbilical cord pulsatility after birth.

THE DURATION OF UMBILICAL CORD PULSATILITY AFTER A VAGINAL DELIVERY IN WOMEN WITH A SINGLETON PREGNANCY AT TERM: AN OBSERVATIONAL STUDY / E.R. Magro Malosso, B. Carotenuto, S. Pinzauti, M. Torricelli, S. D’Ottavio, M. Di Tommaso. - In: JOURNAL OF PEDIATRIC AND NEONATAL INDIVIDUALIZED MEDICINE. - ISSN 2281-0692. - ELETTRONICO. - 6:(2017), pp. 44-45.

THE DURATION OF UMBILICAL CORD PULSATILITY AFTER A VAGINAL DELIVERY IN WOMEN WITH A SINGLETON PREGNANCY AT TERM: AN OBSERVATIONAL STUDY

E. R. Magro Malosso;CAROTENUTO, BIANCA;S. Pinzauti;S. D’Ottavio;M. Di Tommaso
2017

Abstract

INTRODUCTION One of the peculiarities of the umbilical cord is its pulsatility, detectable by palpation, which has often been used to define the optimal timing for cord clamping. Despite being widely used, the exact duration of umbilical cord pulsatility and the possible variables that could significantly affected it are unknown. The primary outcome was the duration of umbilical cord pulsatility, defined as the period in seconds between birth and the end of spontaneous pulsation of the cord. The secondary outcome was the possible association between the duration of pulsatility with maternal, obstetric and neonatal variables. METHODS This is an observational study on women admitted to a tertiary care hospital between February and September 2016. Women with a singleton pregnancy at term who had a spontaneous vaginal delivery and cord clumping at the cessation of pulsations were included in the study. Exclusion criteria were the following: multiple gestation, gestational age at delivery < 37 weeks, cesarean delivery, umbilical cord milking. The collection of pulsatility duration was performed by the same operator through a stopwatch and by manual palpation of the umbilical cord. Based on the average time of pulsatility, the population was divided into two groups: a group with an increased cord pulsatility duration (long-term pulsatility group) and a group with a reduced cord pulsatility duration (short-term pulsatitlity group). The two groups were compared for maternal variables (maternal age, BMI, parity and hemoglobin antepartum), obstetric variables (gestational diseases, the gestational age at delivery, the induction of labor rate, the duration of the first and the second stage of labor, the post-partum blood loss and the umbilical cord length) and neonatal variables (birthweight, cord blood pH, Apgar score, hematocrit and hemoglobin values). Statistical analysis was performed with the Student’s t-tests, Mann-Whitney test and KruskallWallis test for continuous variables and Pearson’s test and Fisher exact test for categorical variables where appropriate. SPSS® version 23 (SPSS Inc, Chicago, IL) was used for statistical analysis and a p-value < 0.05 was considered significant. RESULTS A total of 102 women with a spontaneous vaginal delivery at term were identified. The mean duration of umbilical cord pulsatility after birth was 308.6 ± 244.8 seconds with a range of 39-1,200 seconds. The long-term pulsatility group had similar maternal clinical characteristics compared with the shortterm pulsatility group. The obstetrics variables were similar in both groups. The infants in the longterm pulsatility group had a significantly higher birth weight (3,457.8 ± 392.6 vs 3,279 ± 389.7) and a significantly lower cord blood pH (7.05 vs 7.27) compared with the infants in the shortterm pulsatility group. No differences in the other neonatal outcomes were found. CONCLUSIONS The duration of umbilical cord pulsatility after a vaginal delivery in women with a singleton pregnancy at term was established. The timing of the cord pulsatility may be affected by the birth weight and the cord blood pH but additional studies are necessary to clarify this issue and to identify the potential determinants of the duration of umbilical cord pulsatility after birth.
2017
E.R. Magro Malosso, B. Carotenuto, S. Pinzauti, M. Torricelli, S. D’Ottavio, M. Di Tommaso
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1122475
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