Medical exams on the best time to cut the umbilical cord in the newborn



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Riyadh: Abeer Mubarak

A recent US nursing study showed that the possibility of postponing umbilical cord suspension only a few minutes after the birth of the baby was feasible, to give it a chance to have many health benefits. The community of obstetricians is always looking for the best time to cut the umbilical cord and what are the benefits for the newborn to delay it.

Functional Installation
The umbilical cord is the ligament that unites the fetus with its mother throughout the pregnancy and extends from the navel's hole in the fetal belly to the placenta placenta attached to the placenta lining the uterus. In the fully developed fetus, the umbilical cord is about 50 centimeters long, about two centimeters in diameter, two arteries and a vein, and a blood flow of about a quarter of a liter per minute. The blood vessels are surrounded and protected by an adhesive called Wharton's jelly, all covering a layer of amniotic membrane composed of four elements: a vein, two arteries, a jelly and a warton and an envelope.
The umbilical cord performs several functions, the most important of which is to provide the fetus with oxygen and the nutrients necessary for its life and the development of the growth of the structure of its limbs, as well as for the purification of the fetus from carbon dioxide and other waste accumulated in the body. These surgeries, feeding and purification, are performed by two fetal arteries loaded with harmful substances to rid the body of the fetus, and these two arteries located inside the umbilical cord connecting to the placenta. In the placenta, these harmful substances are extracted from the blood of the fetus, then fed with oxygen and nutrients. The fetal blood then returns from the placenta through a large vein that passes inside the umbilical cord, reaching the opening of the belly button, and enters the bloodstream of the fetus to be distributed to the various organs of the body for to benefit from it.
Towards the end of pregnancy, the placenta allows a group of antibodies to cross the umbilical cord to penetrate the fetus' body and immunize it for the first six months of life to resist a number of microbial diseases.

Delay the cut of the cord
This recent study from the University of Rhode Island in the United States revealed that a five-minute delay in cutting the umbilical cord of the child after birth resulted in two health benefits: first , an increase in the iron stock in his body and another increase in the availability of cerebral myelin in his nervous system, with significant positive effects on the early development of the young child's brain.
The study was published in the December issue of the Journal of Pediatrics, the journal of the American Academy of Pediatrics, which aimed to determine whether it was possible to delay umbilical cord cutting in relation to at the speed of execution in the first minute after the baby's birth.
"When we wait five minutes before cutting the umbilical cord for healthy children and then keeping the baby lean, we will find a little more blood," said Professor Debra E. Erickson Owens, midwife and Professor of Nursing at the University of Rhode Island and lead author of the study. In the placenta, one of the consequences is the return of nearly 50% of iron-rich red blood cells. Therefore, when his brain needs iron for red blood cells to produce myelin, the durability of its iron stores makes a big difference. "

Iron and cerebral myelin
"Our study shows that waiting five minutes or more before cutting the umbilical cord results in myelin formation and can reduce iron deficiency in the child and anemia." "No other study has examined the timing of umbilical cord cutting with the early development of a child's brain, particularly the size of myelin in his nervous system." This was significantly different in our study was the amount of iron and myelin in the brain of children whose umbilical cords were delayed, which was documented by the results of magnetic resonance imaging (MRI) and neurological development.
Myelin is a fatty substance in the brain that encapsulates and envelops all the axons of nerve cells. "Myelin is a very important insulating layer to facilitate rapid transmission of messages across brain neurons," said Professor Eriks Owens. It is assumed that the more efficient myelin conditioning is, the more effective the brain function. Areas of the brain affected by increased availability of myelin are areas associated with motor manufacturing, sensory function, and visual development. What is important to develop at the very beginning of a child's life.
"The researchers have contributed a lot to our understanding of the beneficial effects of a late cut of the umbilical cord," said Dr. James Padbury, MD, head of the pediatric department of the Women and Infants Hospital, and a member of the US Department of Pediatrics. ;Research Team. "This study increases the indicators of iron adequacy associated with an increase in myelin, brain, and this has important implications for children born."

– Consultant in Internal Medicine

The steps are done with care
– Shortly after birth, the midwife cuts the umbilical cord. It should be noted that there is no nerve in the umbilical cord, so it is not painful for the mother or the child. Because the umbilical cord is actually a solid cord and that, medically, it is similar to muscle tension in its hardness, and as the blood passes through it, the completion of the piece requires the use of 39; an appropriately cutting tool, as well as the accuracy of the parts in order to avoid any loss of fetal blood. Sterilize the wound directly connected to the body of the newborn fetus.
Thus, the cord is cut in several stages:
– The cord is first pulled by a sterile plastic forceps at a distance of 3 to 4 cm from the belly button of the fetus.
– Another plastic clip is placed at the other end of the umbilical cord, near the placenta.
– The umbilical cord is cut in the area between the forceps, leaving a piece of umbilical strain 2 to 3 cm or more on the baby's abdomen. This will form the future of the baby's belly during healing.
– The umbilical wound often dries between 5 and 15 days after the birth of the baby and the umbilical cord remains black and then fall automatically without the need to remove the umbilical cord. After the fall of the umbilical cord, it takes between 7 and 10 days to make it disappear completely.
During this time, be sure to clean the area and follow the advice of your doctor to keep it dry and clean. We also advise you to consult your doctor if you notice any bleeding or any change indicating microbial inflammation, such as redness, or a child's body.

Comparisons between beginning and end
– According to the recommendations of the World Health Organization (WHO), it is best to cut the umbilical cord between 1 and 3 minutes after the birth of the baby. The early cut of the umbilical cord (ICC), aged 10 to 30 seconds, is not recommended except in cases of neonatal asphyxia, which requires immediate healing.
DCC is defined medically as being performed between 25 seconds and 5 minutes of the baby's age, which allows the child to recover a blood volume of the placenta approximately one-third of the blood size of his body; He has. This is especially helpful during premature labor, namely the birth of a child before the age of 36 weeks of gestational age. For natural children, the delay in feeding the baby's body increases the number of red blood cells by 60%, increasing blood volume by 30% and reducing the risk of iron deficiency anemia. It is important to note that the lack of iron stock in the child's body is medically considered to have a very negative impact on the development of one's mental abilities and on the normal development of the nervous system.
Despite the earlier belief that delay in the umbilical cord cutter could cause health problems to the baby, such as increased hyperbilirubinemia, respiratory distress and increased body mass red blood cells in the child, polycythemia, many medical sources doubt it, as evidenced by the available data Scientific research especially in these possibilities. It has also not been scientifically proven that this delay in umbilical cord cutting increases the risk of postpartum hemorrhage.

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