Mehmet SATAR, Nilgün BAHAR, Hüseyin ŞİMŞEK, Hacer YAPICIOĞLU, Ferda ÖZLÜ, Selim BÜYÜKKURT

Geciktirilmiş kord klemplemenin term ve geç preterm bebeklerin kısa dönem klinik ve laboratuvar bulgularına etkisi

Amaç: Amerikan Pediatri Akademisi tarafından 2015 protokollerinde doğumdan sonra canlandırma ihtiyacı olmayan bebeklerde kord klemplenmesinin en az 30 dk geciktirilmesi önerilmiştir. Bu çalışmada term ve geç preterm bebeklerde geciktirilmiş kord klemplemenin, hematolojik ve biyokimyasal parametreler, hastaneye yatış, oksijen, mekanik ventilasyon, fototerapi ihtiyacına ve sepsis, hiperbilirubinemi hızına etkisini değerlendirmeyi amaçladık. Yöntem: Prospektif çalışmamıza 34-41 gebelik haftasındaki 86 bebek dahil edildi. Bebekler randomize olarak iki gruba ayrıldı. 43 bebeğin göbek kordonu doğumdan hemen sonra klemplenirken diğer 43 bebeğin kordonu doğumdan 1 dakika sonra klemplendi. Hematolojik ve biyokimyasal parametreler hem kord kanında hem de postnatal 7. günde alınan venöz örneklerde değerlendirildi. Bulgular: Hemoglobin ve hematokrit değerleri hem kord kanında hem de postanal 7. günde her iki grupta da benzerdi. Geciktirilmiş kord klemplenen grupta kord kanında lökosit ve tombosit değerleri istatistiksel olarak anlamlı düşüktü. Geciktirilmiş kord klemplenen grupta kord kanında kreatinin düzeyi anlamlı olarak düşük saptandı. Mekanik ventilasyon ihtiyacı kordu geç klemplenen grupta daha azdı. Hastaneye yatış, sepsis ve hiperbilirubinemi hızı her iki grupta da benzerdi. Sonuç: Geciktirilmiş kord klemplemesinin term ve geç preterm bebeklerde lökosit, trombosit ve kreatinin düzeylerinde düşüklüğe neden olduğu, solunum üzerine olumlu etkileri olduğu düşünüldü.

Effect of delayed cord clamping on short term clinical and laboratory findings in term and late preterm infants

Purpose: Delaying the cord clamping for at least 30 seconds in infants who did not require cardiopulmonary resuscitation after birth has been recommended in the revised guidelines of American Academy of Pediatrics in 2015. We aimed to evaluate the effect of delayed cord clamping on hematological and biochemical parameters, need for hospitalization, oxygen, mechanical ventilation, phototherapy, and on sepsis, hyperbilirubinemia rate in late preterm and term infants. Material and Methods: This prospective study included 86 infants with a gestational age of 34 to 41 weeks. Infants were randomly included in one of two groups. While cords of 43 infants were clamped immediately after birth, cords of the other 43 infants were clamped after one minute. Hematological and biochemical values were evaluated both in cord blood and venous blood samples on 7th day of life. Results: Hemoglobin and hematocrit values were similar in two groups both in cord blood and on 7th day of life. Delayed cord clamping resulted in statistically significant decrease in the leukocyte and platelet coun and creatinine levels in the cord blood. Mechanical ventilation requirement was significantly lower in the delayed cord clamping group. Hospitalization rate, sepsis rate and hyperbilirubinemia rate were similar in both groups. Conclusion: Delayed cord clamping caused lower leucocyte, platelet counts and lower creatinine levels in cord blood. There seems a beneficial effect on respiratory status in late preterm and term infants.

Keywords:

Infants, cord clamping time, creatinine level, leucocyte level, mechanical ventilation,

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