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PERIPrem bundle: Optimal Cord Management

You will have been hard-pressed to miss the international drive for Optimal Cord Management (also referred to as Delayed Cord Clamping, Deferred Cord Clamping or DCC), but the real challenge is to achieve this for all infants, even if they are extremely premature, require resuscitation at delivery or are part of a twin delivery.

It will be key to establish a multi-disciplinary champion group, within or as an extension of your PERIPrem team, to integrate the clinical importance of this into the Perinatal team and to be able to explore the human factors and technicalities of achieving this in a safe, planned way that addresses fears and embeds complex Optimal Cord Clamping into routine practice. There are multiple resources available below, on hand experience of teams who have already established Optimal Cord Clamping for all babies and experienced quality improvement coaches to help your team realise this goal.

We encourage you to look across the three “capsules” of Process, Training and Education and Communications and Engagement when planning and implementing any changes, we know from experience that action needs to be taken across all three capsules to see a progress. These areas will be covered in the unit-level training.

Pay attention to how you will embed and sustain the improvements you have made and you can use the embedding and sustaining change tool (coming soon) to shape your thinking in doing so.

Watch PERIPrem 360 simulation video

This is a 360 training video of a simulated birth of a 28+6 week infant demonstrating the PERIPrem care bundle.

Resources

We have a package of resources to support implementation of this PERIPrem bundle element. Please watch the video above and download the resources to find out more.

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Optimal Cord Management

Please tell us a bit about yourself to download our PERIPrem resources

PERIPrem resources form
PERIPrem resources form

 

Here is a video from our ‘Share and Learn’ series and some additional video resources:

Links for more information

If you would like to understand more about the evidence behind this PERIPrem bundle element, the following papers, reviews and websites have more information.

NNAP (RCPCH) 2020 Audit standards, set by NNAP Project Board.

BAPM: Perinatal Management of Extreme Preterm Birth Before 27 Weeks of Gestation (2019).

Rabe  H, Gyte  GML, Díaz‐Rossello  JL, Duley  L. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database of Systematic Reviews 2019, Issue 9. Art. No.: CD003248. DOI: 10.1002/14651858.CD003248.pub4.

PERIPrem Share and Learn: Delayed Cord Clamping Slide Deck

Randomised trial of cord clamping at very preterm birth: outcomes at 2 years