Delayed Umbilical Cord Clamping - C-section Pilot

Despite expert recommendations to delay clamping the cord for at least 2 minutes, early cord
clamping remains a common obstetrical practice. The World Health Organization has noted that
data on cesarean deliveries are more limited, particularly with respect to long-term effects
in infants. Recently, the American College of Obstetrics and Gynecology also noted in a
committee statement that " the ideal time for clamping of the umbilical cord in cesarean
section vs. vaginal birth is a particularly important area for future research".

The objective of this study is to conduct a pilot trial of delayed cord clamping during
cesarean deliveries to determine if progressively longer intervals of cord clamping are
feasible and not related to poorer maternal and neonatal outcomes as compared to outcomes
from historical controls. We will offer study entry for women planning elective cesarean
delivery to collect prospective data on progressively longer intervals, analyzing outcomes
for each time interval to ensure they are clinically acceptable, prior to extending the
interval another 30 s. We anticipate approximately 20 women at each interval (90 and 120
sec) and will perform hemoglobin analysis on the infants specifically for this study. If
intraoperative blood loss is clinically deemed excessive, or mother or baby are unstable,
the cord will be clamped.

Inclusion Criteria:Subjects that are pregnant (women 18 years of age and older) and
scheduled for an elective C-section at ≥ 37 weeks gestation will be eligible for the
study.

Exclusion Criteria:

Pregnant women that do not plan on having a C-section and individuals that are not
pregnant. Pregnant women that are medically unstable, have poorly controlled diabetes
mellitus, multiple gestations, anomalous fetuses and/or severe intrauterine growth
retardation will be excluded. Adults unable to consent will not be included