ABSTRACT

The methods of umbilical cord tying and cutting the after birth, defined by the technical term 'clamping', have changed over time. We have gone from immediate clamping, performed as soon as the newborn ends expulsion from the birth canal and the cord is still pulsating, to the so-called late clamping, in which the cord is expected to stop pulsing before proceeding with tying and cutting.
Immediate clamping is, together with the administration of oxytocin and traction of the cord, an element of the active management of the third phase of delivery, so today it is still used as a protective modality against the risk of excessive maternal blood loss. Furthermore, the ligation done immediately removes a not negligible amount of blood from the fetus, thus limiting its iron reserves. In order not to steal this blood from the fetus, the cord is not cut immediately after delivery, but the umbilical vein is expected to have emptied and collapsed.
The first systematic review of the literature conducted by Mercer JS in 2001, in fact, highlighted that late clamping had advantages without obvious risks, both in term and preterm infants. In fact, there is disagreement regarding the choice of timing, also due to the lack of clear and homogeneous guidelines.
The proposed research work, based on the data and news collected by the various Operational Units of Obstetrics and Gynecology, present on the Italian peninsula, aims to analyze the effects of maternal and neonatal outcomes related to the choice of the timing of the umbilical cord clamping. at birth and describe the procedures adopted.