Periventricular/intraventricular hemorrhage following early and delayed umbilical cord clamping. A randomized controlled trial.

Objective: To test the hypothesis that early compared with delayed clamping of the umbilical cords of low-birthweight babies may increase the incidence of periventricular/intraventricular hemorrhage (PVH/IVH).

Design: Randomized controlled trial.

Setting: The labor wards of 3 teaching hospitals of the University of the Witwatersrand, Johannesburg.

Hasty clamping of the umbilical cord may initiate neonatal intraventricular hemorrhage.

Intraventricular hemorrhage may result from surges in systemic vascular pressure, particularly when cerebral blood flow autoregulation is impaired by asphyxia, and the germinal matrix vasculature is immature. We postulate that early interruption of umbilical arterial blood flow may cause a rise in blood pressure sufficient to contribute to the development of intraventricular hemorrhage in susceptible neonates.

Postnatal regression of the tunica vasculosa lentis.

Previous studies have shown a good correlation between appearance of the tunica vasculosa lentis (TVL) at birth and gestational age in 27-34 week premature infants. We studied the effect of postnatal age on the rate of regression of the TVL in premature infants to assess whether this occurred at a similar rate to that in utero. Fifty-eight premature infants were enrolled into the study.