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Background: Delayed umbilical cord clamping is recommended in vigorous infants to allow for passage of blood from the placenta to the infant. Oxytocin is administered to mothers soon after birth to decrease the risk of postpartum hemorrhage. It is not known whether oxytocin administered postpartum influences placental transfusion. Objective: To assess the volume of placental transfusion when oxytocin is administered immediately after birth (group A) compared with oxytocin given after clamping the umbilical cord at 3 minutes (group B).
Randomised control trial. Study population: Healthy term infants born vigorous by vaginal delivery with informed consent provided in early labor. Methods: Random numbers were generated by computer program and allocation concealment was performed by opaque, sealed, sequentially numbered envelopes. Oxytocin (10 IU) was given IV within 15 sec. of birth in Group A and after clamping the umbilical cord 3 minutes after delivery in Group B. Soon after birth all infants were weighed at the level of the vagina using a 1g precision scale and subsequently placed on the mother's abdomen or chest. At 3 minutes, in both groups, the cord was clamped and cut and weight was obtained again on the same scale. The primary outcome (volume of placental transfusion) was estimated by the difference in weights (1cc of blood equals 1.05g).T-test and chi-square test were used for group comparison
A total of 144 patients were included from May 2016 to November 2016. There were no differences in the primary outcome: infants in group A (n: 70) gained 86g (SD 48), 95% CI 74-97 and in group B (n: 74) 87g (SD 50), 95% CI 75-98, p=0.92. Hematocrit was 57% (SD 5) in group A and 56.8% (SD 6) in group B. No differences were found in any secondary outcomes including jaundice, polycythemia and maternal postpartum hemorrhage. No clinically relevant adverse events in mothers or infants were recorded.
When umbilical cord clamping is delayed for 3 minutes infants receive a clinically significant placental transfusion which is not modified by the administration of IV oxytocin immediately after birth.