Manfaat Penundaan Penjepitan Tali Pusat

Oleh :

dr. Ashfahani Imanadhia

Berbagai studi telah membuktikan bahwa penundaan penjepitan tali pusat atau delayed cord clamping lebih memberi manfaat baik bagi bayi cukup bulan maupun bayi prematur dibandingkan penjepitan tali pusat segera setelah lahir atau immediate cord clamping.

Penjepitan tali pusat segera yakni di bawah 15-30 detik setelah bayi lahir telah lama dipraktikkan di kebanyakan fasilitas kesehatan. Berdasarkan panduan dari WHO, penjepitan tali pusat sebaiknya dilakukan tertunda yakni tidak kurang dari 1 menit setelah kelahiran atau menunggu saat pulsasi tali pusat telah berhenti.[1]

International Liaison Committee on Resuscitation (ILCOR) juga merekomendasikan penjepitan tali pusat setidaknya 60 detik setelah kelahiran pada bayi cukup bulan yang tidak membutuhkan resusitasi. Sementara American College of Obstetricians and Gynecologists (ACOG) memberi rekomendasi untuk menunda penjepitan tali pusat setidaknya 30-60 detik untuk bayi cukup bulan yang bugar.[3]

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Referensi

1. Becker FG, Cleary M, Team RM, Holtermann H, The D, Agenda N, et al. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. World Health Organ. 2014;7(1):37–72. http://apps.who.int/iris/bitstream/handle/10665/148793/9789241508209_eng.pdf
2. Madar J, Roehr CC, Ainsworth S, Ersdal H, Morley C, Rüdiger M, et al. European Resuscitation Council Guidelines 2021: Newborn resuscitation and support of transition of infants at birth. Resuscitation. 2021;161:291–326. https://pubmed.ncbi.nlm.nih.gov/33773829/
3. American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. Delayed Umbilical Cord Clamping After Birth: ACOG Committee Opinion, Number 814. Obstet Gynecol. 2020 Dec;136(6):e100-e106. doi: 10.1097/AOG.0000000000004167. PMID: 33214530.
4. Bruckner M, Katheria AC, Schmölzer GM. Delayed cord clamping in healthy term infants: More harm or good? Semin Fetal Neonatal Med. 2021;26(2). https://pubmed.ncbi.nlm.nih.gov/33653601/
5. Boere I, Roest AAW, Wallace E, Ten Harkel AD, Haak MC, Morley CJ, et al. Umbilical blood flow patterns directly after birth before Delayed cord clamping. Arch Dis Child Fetal Neonatal Ed. 2015;100(2):F121–5.
6. Mcdonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Evidence-Based Child Heal. 2014;9(2):303–97. https://pubmed.ncbi.nlm.nih.gov/25389141/
7. Zhao Y, Hou R, Zhu X, Ren L, Lu H. Effects of delayed cord clamping on infants after neonatal period: A systematic review and meta-analysis. Int J Nurs Stud. 2019;92:97–108. https://pubmed.ncbi.nlm.nih.gov/30780101/
8. Andersson O, Lindquist B, Lindgren M, Stjernqvist K, Domellöf M, Hellström-Westas L. Effect of delayed cord clamping on neurodevelopment at 4 years of age: A randomized clinical trial. JAMA Pediatr. 2015;169(7):631–8. https://pubmed.ncbi.nlm.nih.gov/26010418/
9. Li J, Yang S, Yang F, Wu J, Xiong F. Immediate vs delayed cord clamping in preterm infants: A systematic review and meta-analysis. Int J Clin Pract. 2021 Nov;75(11):e14709. doi: 10.1111/ijcp.14709. Epub 2021 Sep 1. PMID: 34370357.
10. Kaempf JW, Tomlinson MW, Kaempf AJ, Wu YX, Wang L, Tipping N, et al. Delayed umbilical cord clamping in premature neonates. Obstet Gynecol. 2012;120(2):325–30. https://pubmed.ncbi.nlm.nih.gov/22825092/
11. Brocato B, Holliday N, Whitehurst RM, Lewis D, Varner S. Delayed Cord Clamping in Preterm Neonates: A Review of Benefits and Risks. Obstet Gynecol Surv. 2016;71(1):39–42. https://pubmed.ncbi.nlm.nih.gov/26819134/
12. Datta V, Kumar A, Yadav R. A randomized controlled trial to evaluate the role of brief delay in cord clamping in preterm neonates (34-36 weeks) on short term neurobehavioural outcome. J Trop Pediatr. 2017;63(6):418–24. https://pubmed.ncbi.nlm.nih.gov/28204778/
13. Qian Y, Ying X, Wang P, Lu Z, Hua Y. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes. Arch Gynecol Obstet. 2019;300(3):531–43. https://pubmed.ncbi.nlm.nih.gov/31203386/
14. Surak A, Elsayed Y. Delayed cord clamping: Time for physiologic implementation. J Neonatal Perinatal Med. 2021;1–9. https://pubmed.ncbi.nlm.nih.gov/34219673/
15. Lewis D, Varner S. CME Review Article. Pediatr Emerg Care. 2017;33(12):792–3. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000329
16. Dipak NK, Nanavati RN, Kabra NK, Srinivasan A, Ananthan A. Effect of delayed cord clamping on hematocrit, and thermal and hemodynamic stability in preterm neonates: A randomized controlled trial. Indian Pediatr. 2017;54(2):112–5. https://pubmed.ncbi.nlm.nih.gov/28285280/
17. Fenton C, McNinch NL, Bieda A, Dowling D, Damato E. Clinical Outcomes in Preterm Infants Following Institution of a Delayed Umbilical Cord Clamping Practice Change. Adv Neonatal Care. 2018;18(3):223–31.
18. Mercer JS, Erickson-Owens DA, Collins J, Barcelos MO, Parker AB, Padbury JF. Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: A randomized controlled trial. J Perinatol. 2017;37(3):260–4. https://pubmed.ncbi.nlm.nih.gov/27929530/
19. Nesheli HM, Esmailzadeh S, Haghshenas M, Bijani A, Moghaddams TG. Effect of late vs early clamping of the umbilical cord (on haemoglobin level) in full-term neonates. J Pak Med Assoc. 2014 Nov;64(11):1303-5. PMID: 25831651.
20. Nakagawa M, Ishida Y, Nagaoki Y, Ohta H, Shimabukuro R, Hirata M, et al. Correlation between umbilical cord hemoglobin and rate of jaundice requiring phototherapy in healthy newborns. Pediatr Int. 2015;57(4):626–8. https://pubmed.ncbi.nlm.nih.gov/25533043/