Delayed Versus Immediate Umbilical Cord Clamping

Shanterra Grable, Mercer University College of Pharmacy

Delayed umbilical cord clamping is performed from 25 seconds to five minutes after birth. The practice is thought to allow more blood to transfer from the placenta to the newborn, possibly increasing the baby’s blood volume by 30%. The American Congress of Obstetricians and Gynecologists (ACOG) supports delayed cord clamping in preterm infants but not in full term infants due to insufficient evidence showing benefits. The current standard during delivery  is to clamp the umbilical cord 10 to 30 seconds immediately after birth.  [1]

One of the associated benefits of delayed clamping is decreased risk of iron deficiency anemia due to transfer of additional 40 to 50 mg/kg of iron from the placenta to the infant. [1] Prior randomized controlled trials found that delayed cord clamping in preterm infants less than 32 weeks gestational age had lower instances of mortality, necrotizing enterocolitis, and infection than infants with immediate cord clamping; however, these studies did not show if delayed cord clamping is the sole factor leading to mortality and neurodevelopmental benefits. Despite the potential benefits, delayed clamping is not a universal practice due to concerns of delayed resuscitation and hyperbilirubinemia.  The following study was performed to add knowledge regarding the effects of delayed clamping on death and major morbidity in preterm infants. [2]

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Association Between Preeclampsia and Congenital Heart Defects

Sarah Vo, Mercer University College of Pharmacy

Congenital heart defects (CHD) are suggested to be the most common anomalies in infants.  It is said that it affects every eight births per 1,000. [1]

According to Mayo Clinic, CHD is when the structure of a child’s heart has problems.  These problems are said to include a small hole between heart chambers that closes on its own, obstructed blood flow, or abnormal blood vessels.  Environmental and genetic risk factors are considered to play a role in CHD, including diabetes, medications, or drinking alcohol during pregnancy.  [2]

Preeclampsia is a pregnancy complication associated with high blood pressure per Mayo Clinic.  Preeclampsia is suggested to occur after 20 weeks of pregnancy in a woman whose blood pressure had been normal and can cause serious complications for the mother and baby. [3]

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Less-tight versus tight control of hypertension in pregnancy

Diana Lee, PharmD Candidate 2015 Mercer University College of Pharmacy

Hypertension during pregnancy occurs in approximately 10% of all pregnant women. Gestational and preexisting hypertension before 34 weeks are associated with an increased risk of perinatal and maternal complications, such as intracerebral hemorrhage, poor fetal growth and well-being. The treatment of severe hypertension during pregnancy (>160/110 mm Hg) is considered to be well established. However, the benefit of antihypertensive therapy for mild-to-moderately elevated blood pressure (< 160/110) have not been demonstrated.1 Continue reading