Delayed cord clamping is contraindicated in:

Appeared in: IGNOU PB. Bsc. Nsg. Entrance-2025

Explanation

In Rh incompatibility, an Rh-negative mother produces antibodies against her Rh-positive fetus's red blood cells.
Delayed cord clamping allows more of this antibody-rich maternal blood to transfer to the newborn after birth.
This increased transfer of antibodies worsens the destruction of the baby's red blood cells (hemolysis).
Severe hemolysis leads to dangerous levels of anemia and hyperbilirubinemia (jaundice), which can cause brain damage (kernicterus).
Therefore, immediate cord clamping is required to minimize the transfer of these harmful antibodies and reduce the severity of the disease in the newborn.

Option A: Delayed cord clamping is actually beneficial for a baby born to an anemic mother.
Option B: A birth weight over 3 kg typically signifies a healthy, term infant, for whom delayed cord clamping is the standard of care.
Option C: Delayed cord clamping is recommended for stable preterm babies.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Contraindications for Delayed Cord Clamping (DCC) as background academic context rather than a clinical decision trigger.
A nurse must review the maternal history for blood type and Rh status. If the mother is Rh-negative and unsensitized or sensitized, the team must be prepared for immediate cord clamping at delivery.
This is a critical patient safety issue, as delaying the clamping in this specific situation can significantly worsen the newborn's prognosis and increase the need for intensive interventions like exchange transfusions.
What if? If an Rh-incompatible baby is also born with severe birth asphyxia? Immediate clamping is still the correct action, as the priority shifts to immediate neonatal resuscitation, which cannot be performed while the cord is intact.

How to Approach the Question

First, identify the core concept of the question: it asks for a contraindication to delayed cord clamping (DCC), meaning a situation where it should NOT be done.
Recall the general principle of DCC: it allows for placental transfusion, which is beneficial for most newborns by increasing blood volume and iron stores.
Evaluate each option to see if it represents a situation where this placental transfusion would be harmful.
Option A (anemic mother): The baby would benefit from more blood/iron. This is an indication, not a contraindication.
Option B (birth weight > 3 kg): This is a healthy term baby who would benefit from DCC. This is an indication.
Option C (preterm baby): These babies benefit from increased blood volume and reduced complications. This is an indication.

Concept Tested & Keywords

QaUbJIGG5yOf_CWWjOlxE1

E6 Obstetrics Williams pp. 5-15, 15-32

Practise the full IGNOU PB. Bsc. Nsg. Entrance-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.