A woman is delivering at 28 weeks gestation due to preterm labor. Which intrapartum intervention reduces the risk of intraventricular hemorrhage and the need for donor blood transfusion in her infant?
- A Intravenous magnesium sulfate given to the mother shortly before delivery
- B Immediate cord clamping followed by cord blood milking toward the infant
- C Delayed umbilical cord clamping for 30 to 60 seconds with the baby held below the placenta level where feasible ✓
- D Prophylactic surfactant instilled in the delivery room within the first minute
Correct answer: C. Delayed umbilical cord clamping for 30 to 60 seconds with the baby held below the placenta level where feasible
Explanation
Delayed cord clamping for 30 to 60 seconds in preterm deliveries provides placental transfusion, reducing intraventricular hemorrhage, necrotizing enterocolitis, and transfusion requirement. Cord milking is discouraged in very preterm infants because of concern for IVH. Antenatal magnesium sulfate is used for neuroprotection, and prophylactic surfactant addresses respiratory distress syndrome, neither of which lowers IVH risk through volume effects.
Reference: Cloherty and Stark's Manual of Neonatal Care, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.