Cut the umbilical cord after delivery should be done.

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Obstetrics and Midwifery Nursing

Medium

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Waiting for the umbilical cord to stop pulsating before clamping is known as Delayed Cord Clamping (DCC), the recommended standard of care for vigorous newborns.
This delay, typically 30-60 seconds or more, allows for placental transfusion, where a significant volume of oxygenated, iron-rich blood is transferred from the placenta to the baby.
This practice increases the newborn's total blood volume, boosts iron stores, and significantly reduces the risk of iron-deficiency anemia in infancy.
Major health organizations, including the WHO and the American College of Obstetricians and Gynecologists (ACOG), endorse DCC for both term and preterm infants who do not require immediate resuscitation.

Option A: This is called Early Cord Clamping (ECC). It deprives the newborn of the final placental blood transfer, increasing the risk of anemia.
Option C: This is an excessive and unnecessary delay. Placental transfusion is complete once the cord stops pulsating.
Option D: This is an excessively long delay. The transfer of blood is typically complete within 1 to 5 minutes after birth, which corresponds to the cessation of pulsations.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Optimal timing of umbilical cord clamping after delivery as background academic context rather than a clinical decision trigger.
Nurses play a key role in advocating for and implementing delayed cord clamping as per hospital policy, ensuring the newborn receives the full benefits of placental transfusion.
The nurse must be able to quickly assess the newborn's condition at birth to determine if they are vigorous and eligible for DCC or if they require immediate resuscitation, which would necessitate early clamping.
What if? If the newborn is born apneic, limp, and with a heart rate below 100 bpm, the priority shifts to resuscitation. The cord should be clamped immediately to move the baby to the warmer for life-saving interventions, as the need for effective ventilation outweighs the benefits of DCC.

How to Approach the Question

This is a procedural question asking for the best practice based on current evidence.
First, identify the core topic: the timing of umbilical cord cutting.
Recall the current guidelines from major health bodies like WHO and ACOG regarding this procedure.
Evaluate the options based on the physiological process of placental transfusion. The key event is the transfer of blood, which continues as long as the cord is pulsating.
Eliminate options that are too early ('Immediately') or too late ('After expulsion of placenta', '10 minutes') relative to the physiological process.
Select the option that aligns with the physiological endpoint of placental transfusion, which is the cessation of pulsation.

Concept Tested & Keywords

QVCi0W3J2vP9yOX2NgqRtY

E6 Obstetrics Williams p. 5-15

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1079-1081