Placental Transfusion Strategies in Italy: A Nationwide Survey of Tertiary-Care Delivery Wards

Am J Perinatol. 2017 Jun;34(7):722-728. doi: 10.1055/s-0036-1597995. Epub 2017 Jan 6.

Abstract

Objective Delayed umbilical cord clamping and cord milking are placental transfusion strategies that produce higher iron stores and better hemodynamic conditions in a newborn. We aimed to evaluate their current practice in tertiary-care delivery wards in Italy. Study Design A multiple-choice questionnaire was e-mailed to all the 101 Italian tertiary-care delivery wards. The comparative analysis between categorical variables was performed by the χ2 test. Result We obtained an 85% (86/101) response rate. Where placental transfusion strategies were applied, in 61% of cases they were performed in less than half of deliveries. Obstetric-neonatal guidelines were available in 21% of the centers. Where they were available, application of delayed clamping and milking was significantly more frequent and clamping time was longer. Conclusion This first Italian nationwide survey on placental transfusion strategies showed low application rate and variability in knowledge and execution. Availability of obstetric-neonatal guidelines, knowledge of benefits, and cooperation within the delivery team were associated with enhanced implementation.

Publication types

  • Multicenter Study

MeSH terms

  • Blood Transfusion / methods
  • Blood Transfusion / statistics & numerical data*
  • Constriction
  • Delivery, Obstetric / statistics & numerical data*
  • Female
  • Humans
  • Infant, Newborn
  • Italy
  • Perinatal Care / organization & administration
  • Perinatal Care / standards*
  • Placental Circulation*
  • Practice Guidelines as Topic
  • Pregnancy
  • Surveys and Questionnaires
  • Time Factors
  • Umbilical Cord / blood supply*
  • Umbilical Cord / surgery