The Impact of Early versus Delayed Umbilical Cord Clamping on Maternal and Neonatal Outcomes among Women with Preeclampsia and Preterm Cesarean Section Delivery

Background: Every infant's umbilical cord is clamped and severed at delivery, albeit there is disagreement over when this procedure should be performed. Objective: This research aimed to fill the gap in the literature and identify the impact of delayed umbilical cord clamping (UCC) in patients with preeclampsia (PE) and undergoing preterm cesarean delivery. Patients and Methods: This randomized clinical trial was carried out at Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University Hospitals on (60) women diagnosed with severe PE with gestational age (GA) between 28 and 37 weeks. On the day of the scheduled surgery, patients were randomly assigned to two equal groups; the early clamping group (umbilical cord was clamped within 15 seconds) and the delayed clamping group (umbilical cord was clamped at 60 seconds). Both groups were compared regarding maternal blood loss, neonatal hemoglobin and hematocrit within 2 hours after delivery, initial neonatal serum bilirubin at 6 hours of age and Apgar scores at 1 and 5 minutes. Results: Post delivery neonatal hemoglobin levels and Apgar scores were statistically significant higher among cases of DCC group; 10.39±0.28 vs. 9.38±0.41 g/dl. Also, intra-, postoperative and total estimated blood loss was statistically significantly lower among cases of DCC group; 275.68±71.68 vs. 318.96±76.55, 204.91±49.18 vs. 257.28±66.89 and 480.59±120.86 vs. 576.24±143.44 ml respectively. However, No variations were seen between research groups for baseline maternal features, hemodynamics, hemorrhage profiles, and post-delivery neonatal total and direct bilirubin levels. Conclusion: Maternal and neonatal outcomes are improved by delaying umbilical cord clamping.