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Gynaecology & Obstetrics Miscellaneous (Gynae) eaea8319

Allowing the cord blood passage to fetus before clamping the umbilical cord should be AVOIDED to prevent

A
Maternal alloimmunization
B
Prematurity
C
Growth retardation of fetus
D
All of the above
High-Yield Explanation
Ans. a (Maternal alloimmunization) (Ref. Williams Obstetrics 22nd/Chapter 17; p. 431, 663)CLAMPING THE CORDThe umbilical cord is cut between two clamps placed 4 to 5 cm from the fetal abdomen, and later an umbilical cord clamp is applied 2 to 3 cm from the fetal abdomen. A plastic clamp that is safe, efficient, and fairly inexpensive.Timing of Cord ClampingIf after delivery, the newborn is placed at or below the level of the vaginal introitus for 3 minutes and the fetoplacental circulation is not immediately occluded by clamping the cord, an average of 80 mL of blood may be shifted from the placenta to the neonate. This provides about 50 mg of iron, which reduces the frequency of iron deficiency anemia later in infancy.Accelerated destruction of erythrocytes, as found with maternal alloimmunization, forms additional bilirubin from the added erythrocytes and contributes further to the danger of hyperbilirubinemia. Although the theoretical risk of circulatory overloading from gross hypervolemia is formidable, especially in preterm and growth-retarded neonates, the addition of placental blood to the otherwise normal newborn's circulation ordinarily does not cause difficulty.

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