Optimal Umbilical Cord Management
The 2021-2022 Maternity & Neonatal Safety Improvement programmes focused on optimal cord management in babies born at less than 34 weeks, where the umbilical cord is not clamped until 60 seconds after birth.
Evidence shows that optimal cord management reduces death in preterm babies by nearly a third by reducing the risk of brain haemorrhage. (BAPM, 2020) | |
It also reduces the need for blood transfusions by around 10%. (BAPM, 2020) | |
Data reporting in 2021/22 suggests that 88 more babies received optimal cord management. |
This intervention is recommended by the World Health Organisation because following delivery of a baby the placenta and cord continue to transfer valuable cord blood to the baby whilst they transition to life outside their mother. There are exceptions in a small number of cases where maternal or fetal conditions justify earlier clamping.
Evidence shows that optimal cord management reduces death in preterm babies by nearly a third by reducing the risk of brain haemorrhage. It also reduces the need for blood transfusions by around 10%. (BAPM, 2020).
Research tells us that the number of babies needing to receive optimal cord clamping to prevent a death is around 30 – 50 overall and may be as low as 20 in the least mature babies (BAPM, 2022). Data reporting in 2021/22 suggests that 88 more babies received optimal cord management when compared to the previous year, which means that, based on the figure of 30 – 50 interventions to prevent a death, between 1 – 3 deaths were prevented, with many more babies also benefitting by reducing the need for blood transfusions.
The NENC team has been working alongside the Northern Neonatal Network, Maternity Clinical Network for NENC, NENC Local Maternity and Neonatal System (LMNS), and Trusts from around the region to increase the use of optimal cord management.
At the start our data told us that our baseline was 18% (Jan 20 – March 21). This figure was low due to a combination of the intervention not always taking place and some inaccurate recording. By March 2022 we were regularly seeing monthly reporting of over 50%.
We will continue to work on optimal cord management in 2022/23 and expect to see these figures improve further.
BAPM, 2020: OCM_Toolkit_Full_For_Launch.pdf https://www.bapm.org/pages/197-optimal-cord-management-toolkit