الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
There are two contrasting approaches to managing the third stage of labor: expectant or physiological management and active management. A comparison of these approaches is the subject of a separate Cochrane review (Prendiville, 2009).
Expectant management is a non-interventionist approach to care in the third stage of labor that involves waiting for signs of placental separation and allowing the placenta to deliver spontaneously or aided by gravity, maternal effort or nipple stimulation. In many high-resource settings, and in some low-resource settings, this approach has frequently been replaced by more interventionist packages of care (active management), although variation in practice remains widespread (McDonald, 2009).
Active management has involved the clinician intervening in the process through three interrelated processes: the administration of a prophylactic uterotonic drug; cord clamping and cutting; and controlled traction of the umbilical cord (McDonald, 2007 ).
Early cord clamping was part of active management of labor. In the past, as part of an active management strategy, the umbilical cord has usually been clamped shortly following birth of the infant. This was generally advised to be carried out in the first 30 seconds after birth, regardless of whether the cord pulsation has ceased (Mcdonald, 2009).
Late cord clamping, or delayed clamping, a physiological approach, involves clamping the umbilical cord when cord pulsation has ceased. However, definitions of what constitutes early and late cord clamping vary (Prendiville, 2009).
SUMMARY
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The Cochrane review 2013 found that DCC babies had significantly higher body iron stores than ECC babies, an increase that persisted for months.
The Cochrane review 2013 did not find Maternal adverse outcomes: The review found no significant ECC-versus-DCC differences in any maternal outcomes, including postpartum hemorrhage, length of the third stage of labor, need for blood transfusion, and need for manual removal of the placenta.
Added to the same reference, they did not find Neonatal adverse outcomes: Similarly, with the single exception of a slight increase in the need for phototherapy to treat hyperbilirubinemia , there were no significant differences between ECC and DCC babies in neonatal outcomes such as mortality, Apgar scores < 7 at five minutes, need for resuscitation, NICU admission, respiratory distress, polycythemia, and clinical jaundice.
The current study aimed at determining the effects of early cord clamping compared with late cord clamping after birth on maternal and neonatal outcome.
The present study was conducted at University Hospital, Teaching Hospital, and New General Bagour Hospital in Menoufia University. Research hypotheses and comparitive design (a subtype of the quasi-experimental design) were used in carrying out the study.
The target population of this study was women from the previous selected hospitals during third stage of labor after delivery of the newborn but before umbilical cord clamping to perform the main study intervention either early or delayed clamping and withdraw blood sample
SUMMARY
67
from the mother and her newborn at birth and then after 24hrs.The accessible population in this study and fulfill the inclusion criteria. A convenient sample was recruited. The inclusion criteria were as follow:
* Third stage of normal labor.* Vertex presentation.* Primi para.
* Free from any medical disease.* Singleton pregnancy. * Uterotonic administration before cord clamping. (Oxytocin administration).
The sample was collected during six months. The target population was 100 women divided into early and delayed umbilical cord clamping groups.
Throughout the course of the study, data were collected using three tools. Two tools which were developed by the researcher and reviewed by a jury of qualified experts, then tested for validity and reliability. The third tool was used but not developed by the researcher. Tools were the followings:-
Tool I: Tool I: Tool I: Tool I: Tool I: Tool I: Tool I: Structured Structured Structured Interview QuestionnaireInterview Questionnaire Interview QuestionnaireInterview QuestionnaireInterview QuestionnaireInterview QuestionnaireInterview QuestionnaireInterview Questionnaire Interview Questionnaire Interview QuestionnaireInterview QuestionnaireInterview QuestionnaireInterview Questionnaire Interview QuestionnaireInterview QuestionnaireInterview QuestionnaireInterview Questionnaire (Appendix ppendix ppendix ppendix I): This tool was devoted to select the eligible study subjects that fulfill This tool was devoted to select the eligible study subjects that fulfill This tool was devoted to select the eligible study subjects that fulfill This tool was devoted to select the eligible study subjects that fulfill This tool was devoted to select the eligible study subjects that fulfill This tool was devoted to select the eligible study subjects that fulfill This tool was devoted to select the 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The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts: proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts: proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts: proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. The tool consisted of the following parts:proposed inclusion criteria. 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Part 1.Part 1.Part 1. Part 1.Part 1. Soci SociSociodemographic charaodemographic charaodemographic chara odemographic charaodemographic charaodemographic chara odemographic charaodemographic charaodemographic chara odemographic charaodemographic charaodemographic chara odemographic characteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings cteristics which include the followings (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation). (age, level of education, and occupation).
Part Part Part 2. Obstetric historObstetric historObstetric historObstetric historObstetric histor Obstetric historObstetric historObstetric histor Obstetric historObstetric historObstetric historObstetric historObstetric historObstetric history which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, y which includes the followings (gestational age, duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord duration of third stage labor, receiving uterotonics before cord clamping). clamping). clamping).clamping).clamping).clamping).clamping).
Tool II: Tool II: Tool II: Tool II: Tool II: Tool II: Tool II: Tool II: Structured Structured Structured Structured Structured Structured Assessment ToolAssessment ToolAssessment ToolAssessment ToolAssessment ToolAssessment ToolAssessment ToolAssessment Tool Assessment ToolAssessment ToolAssessment ToolAssessment Tool (Appendix IIAppendix II Appendix IIAppendix IIAppendix IIAppendix II): This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment This assessment tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the 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researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data tool was designed and used by the researcher to collect necessary data about maternal and neonatal outcomes 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SUMMARY
68
Part Part Part 3. Maternal outc aternal outc aternal outc aternal outcaternal outcaternal outcaternal outcaternal outcomesomesomes which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood which include the followings (maternal blood loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, loss, maternal hemoglobin, and hematocrite {at birth after 24hrs}, manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion) manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion)manual removal of the placenta and need for blood transfusion).
Part Part Part 4. Neonatal outcomes eonatal outcomeseonatal outcomeseonatal outcomeseonatal outcomes eonatal outcomeseonatal outcomeseonatal outcomeseonatal outcomeseonatal outcomes eonatal outcomeseonatal outcomes which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, which include the followings (apgar score, Neonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth eonatal {hemoglobin, hematocrite, ferritin, RBCs and bilirubin}at birth and after 24hrs). and after 24hrs).and after 24hrs). and after 24hrs). and after 24hrs).and after 24hrs).and after 24hrs). and after 24hrs).
Tool III:Tool III:Tool III:Tool III:Tool III: Tool III:Tool III:Tool III: Apgar score Apgar score Apgar score Apgar score Apgar score Apgar score Apgar score Apgar score (Appendix III): (Appendix III): (Appendix III):(Appendix III): (Appendix III):(Appendix III):(Appendix III):
This tool was used by the researcher to collect the necessary data about the neonatal condition. This tool is determined by evaluating the newborn baby at the first and the fifth minutes after birth on five simple criteria (Appearance, Pulse, Grimace, Activity and Respiration) on a scale from zero to two, then summing up the five values. The researcher used this tool through apgar core chart.
Part 5. Apgar score chart.
Approaches to ensure ethics were considered in the study regarding confidentiality and the informed consent. Confidentiality was achieved by the use of locked sheets with the names of the participating women replaced by numbers. All women were informed that the information they provided during the study would be kept confidential and used only for statistical purpose and after finishing the study. The findings would be presented as group data with no personal information remained.
After explanation prior to enrollment in the study, informed consent was obtained verbally from all women. Each woman was informed that participation in the study was voluntary, and that she could withdraw from the study whenever she decided to. Each one was given the
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opportunity to freely refuse participation. They were free to ask any question about the study details.
The main findings of the current study were as follows:
The current study findings showed no statistically significant difference regarding gestational age for nearly two third of the participants (62%)and nearly half of the participants (52%) in early and delayed cord clamping respectively.
The current study findings showed statistically significant difference at P value 0.03 regarding duration of third stage of labor (less than 20 minutes) for nearly two third of the participants (66%) in early clamping group and nearly two fifth of the participants (42%)in delayed clamping group.
The current study findings showed no statistically significant difference regarding receiving uterotonics before cord clamping for nearly majority participants (96% and 92%) in early and delayed cord clamping groups respectively.
The current study findings showed statistically significant difference at P value 0.004 regarding estimated maternal post partum blood loss (mild less than 500ml) for nearly three fourth of the participants (72%)in early clamping group and nearly half of the participants (42%) in delayed clamping group .
The current study findings showed no statistically significant difference regarding maternal hemoglobin, hematocrite level at birth and after 24hrs.
The current study findings showed all participants (100%) in early and delayed cord clamping groups not need for blood transfusion and manual removal of the placenta.
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The current study findings showed no statistically significant difference regarding apgar score for nearly two third of the participants (66%)in early clamping group and nearly five sixth of the participants (84%)in delayed clamping group had normal apgar score ranged between (7-10).
The current study findings showed statistically significant difference at P value 0.004 regarding neonatal hemoglobin level at birth for nearly half of the participants (48%)in early clamping group and nearly three fourth of the participants (78%)in delayed clamping group had hemoglobin ranged from(14.5-22.5mg/dl) .
The current study findings showed statistically significant difference at P value 0.002 regarding neonatal hematocrite level and RBCs at birth for nearly half of the participants (46%)in early clamping group and nearly three fourth of the participants (78%)in delayed clamping group had hematocrite ranged from(45-65%) .
The current study findings showed statistically significant difference at P value 0.002 regarding neonatal ferritin level at birth for nearly half of the participants (46%)in early clamping group and nearly three fourth of the participants (78%)in delayed clamping group had ferritin level ranged from(27-330pmol) .
The current study findings showed no statistically significant difference regarding neonatal bilirubin level at birth for nearly two third of the participants (64%) in early clamping group and nearly three fourth of the participants (78%)in delayed clamping group had bilirubin level ranged from(2-5mg/dl) .
The current study findings showed highly statistically significant difference at P value <0.001 regarding neonatal hemoglobin level after 24hrs for nearly half of the participants (56%)in early
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clamping group and nearly four fifth of the participants (80%) in delayed clamping group had hemoglobin level ranged from (14.5-22.5g/dl).
The current study findings showed highly statistically significant difference at P value <0.001 regarding neonatal hemmatocrite level after 24hrs for nearly half of the participants (56%)in early clamping group and nearly four fifth of the participants (80%) in delayed clamping group had hemoglobin level ranged from (45-65%).
The current study findings showed highly statistically significant difference at P value <0.001 regarding neonatal RBCs level after 24hrs for nearly half of the participants (56%)in early clamping group and nearly four fifth of the participants (80%) in delayed clamping group had hemoglobin level ranged from (4.8-7.2M/UL).
The current study findings showed highly statistically significant difference at P value <0.001 regarding neonatal ferritin level after 24hrs for nearly half of the participants (56%)in early clamping group and nearly four fifth of the participants (80%) in delayed clamping group had hemoglobin level ranged from (27-330pmol/L).
The current study findings showed statistically significant difference at P value 0.003 regarding neonatal bilirubin count after 24hrs for nearly three fourth of the participants (72%)in early clamping group and nearly four fifth of the participants (80%)in delayed clamping group ranged from (2-5mg/dl).
All participants not admitted to NICU (Neonatal intensive Care Unit ) in both early and delayed clamping group.