Geciktirilmiş Umbilikal Kordon Klemplemenin Yenidoğan Sağlığına Etkisi

Abstract

Doğum sırasında bebeğin doğumu ile umbilikal kordonun klemplenmesine kadar geçen sürede kanın plasentadan bebeğe transferi “plasental transfüzyon” olarak tanımlanmaktadır. Erken kordon klempleme plasental transfüzyonun doğal sürecini engelleyen fizyolojik olmayan bir uygulamadır. Geciktirilmiş kordon klempleme doğumda plasentadan yenidoğana kan transferini sağlar. Fetoplasental total kan volümünün %25-60’ı ve fetal kırmızı kan hücrelerinin %60’ı plasental sirkülasyonda bulunur ve bu kan hematopoetik kök hücreleri yönünden zengindir. Plasental transfüzyon, yenidoğanın başarılı postnatal fizyolojik geçişinde önemli etkilere sahip olabilmektedir. Bebeğin doğum sonrası yeterli kan hacmi ile doğmuş olması sonraki yaşamındaki sağlık ve iyilik halini önemli ölçüde etkilemektedir. Son zamanlarda, yenidoğana plasental transfüzyon sağlanmasının önemi konusunda bir dizi çalışma yapılmıştır. Kanıtlar ile geç kordon klemplemenin yararları ortaya konulmuş olmakla birlikte kordon klempleme ile ilgili terminaloji ve ideal kordon klempleme zamanı konusunda fikir birliği bulunmamaktadır. Sağlık bakım sağlayıcıları hala erken kordon klemplemeyi uygulamakta, klempleme zamanında kurumlar ve kişiler arası farklılıklar bulunabilmektedir. Optimal kordon klempleme zamanını belirlemeye yönelik çalışmalar yapılarak kordon klempleme uygulaması standardize edilmeli ve ulusal kılavuzlar geliştirilmelidir.

Keywords

• Plasental dolaşım,umbilikal kordon,klempleme,anemi,yenidoğan

Effect of Delayed Umbilical Cord Clamping on Newborn Health

Abstract

It is defined that transfer from blood placenta to baby as "placental transfusion" during the time of birth and until the umbilical cord is clamped. Early cord clamping is an avoidable, unphysiologic intervention that prevents the natural process of placental transfusion. Delayed cord clamping provides blood transfer from the placenta to the newborn at birth. 25-60% of fetal placental total blood volume and 60% of fetal red blood cells are present in the placental circulation and this blood is rich in part of hematopoietic stem cells. Placental transfusion may have significant effects on the successful postnatal physiological transition of the newborn. Baby’s birth, after birth with enough blood volume significantly affects the health and well-being of his later life. Recently, a number of studies have been conducted on the importance of providing placental transfusion to the newborn. There is no consensus on the timing of ideal cord clamping and terminology of cord clamping, as evidenced by the benefits of delayed cord clamping with evidence. Health care providers have still applied early cord clamping and there might be differences between institutions and individuals at clamping time. Cord clamping application should be standardized and national guidelines should be developed by studying to determine the optimal cord clamping time.

Keywords

• Placental circulation,umbilical cord,constriction,anemia,newborn

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