How much amount of blood transfers from placenta to the baby after delivery when the cord clamping is delayed till the cessation of cord pulsations?

1. A

   10-30 ml

2. B

   120-150 ml

3. C

   40-60 ml

4. D

   80-100 ml

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

• Delayed cord clamping (DCC) until pulsations stop allows for a significant transfer of blood from the placenta to the newborn, a process called placental transfusion.
• In a term infant, this transfusion provides an additional 80-100 ml of blood.
• This volume increases the baby's total blood volume and provides a substantial amount of iron, which is crucial for development.
• The increased iron stores from DCC help prevent iron deficiency anemia during the first year of life, a key benefit highlighted in clinical guidelines.

Why Other Options Were Wrong

• Option A: This volume is too small to account for the significant physiological benefits, such as preventing anemia, that are associated with delayed cord clamping.
• Option B: This volume is too high for the average placental transfusion. While the placenta holds a significant amount of blood (around 45 ml/kg of fetal weight), it is unlikely that the entire volume is transferred.
• Option C: This amount is less than what is typically transferred when waiting for cord pulsations to cease. A delay of only 30 seconds might result in this volume, but a longer delay allows for a more complete transfusion.

Related Visual

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Physiology of Placental Transfusion and Delayed Cord Clamping in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• Nurses are instrumental in implementing delayed cord clamping protocols, advocating for the practice when appropriate, and educating parents about its benefits.
• Post-delivery, nurses monitor newborns for signs of polycythemia (an abnormally high concentration of red blood cells) and hyperbilirubinemia (jaundice), which are potential but generally low-risk side effects of DCC.
• What if? the newborn is preterm? For preterm infants, DCC is even more crucial. It is associated with improved circulatory stability, reduced need for blood transfusions, and a lower incidence of serious complications like intraventricular hemorrhage and necrotizing enterocolitis.

How to Approach the Question

• First, identify the key concept in the question: the volume of blood transferred during 'delayed cord clamping' until 'cessation of cord pulsations'.
• Recall the physiological process of placental transfusion, where blood flows from the placenta to the baby after birth.
• Remember that this practice is recommended because it provides significant benefits to the newborn, implying a substantial amount of blood is transferred.
• Evaluate the given options. 10-30 ml and 40-60 ml are relatively small volumes and unlikely to cause major physiological changes like preventing anemia.
• The option 120-150 ml represents a very large volume, close to the entire placental reserve, which is less likely to be the typical amount transferred.
• Select the option 80-100 ml, as it represents a physiologically significant volume that aligns with the known benefits of increased iron stores and blood volume from delayed cord clamping.

Concept Tested & Keywords

• Concept Tested: Physiology of Placental Transfusion and Delayed Cord Clamping
• Stem keywords: blood transfer, placenta, delayed cord clamping, cessation of cord pulsations
• Lead-in keywords: How much amount
• Negative lead-in flag: false

Question ID

Qf1W3yzcBXFXwhzFFkvoFK

Copy ID

Reference Book

E6 Obstetrics Williams p. 5-14