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Baby-directed umbilical cord clamping: A feasibility study.

Abstract：

INTRODUCTION:Over five percent of infants born worldwide will need help breathing after birth. Delayed cord clamping (DCC) has become the standard of care for vigorous infants. DCC in non-vigorous infants is uncommon because of logistical difficulties in providing effective resuscitation during DCC. In Baby-Directed Umbilical Cord Clamping (Baby-DUCC), the umbilical cord remains patent until the infant's lungs are exchanging gases. We conducted a feasibility study of the Baby-DUCC technique. METHODS:We obtained antenatal consent from pregnant women to enroll infants born at ≥32 weeks. Vigorous infants received ≥2 min of DCC. If the infant received respiratory support, the umbilical cord was clamped ≥60 s after the colorimetric carbon dioxide detector turned yellow. Maternal uterotonic medication was administered after umbilical cord clamping. A paediatrician and researcher entered the sterile field to provide respiratory support during a cesarean birth. Maternal and infant outcomes in the delivery room and prior to hospital discharge were analysed. RESULTS:Forty-four infants were enrolled, 23 delivered via cesarean section (8 unplanned) and 15 delivered vaginally (6 via instrumentation). Twelve infants were non-vigorous. ECG was the preferred method for recording HR. Two infants had a HR < 100 BPM. All HR values were >100 BPM by 80 s after birth. Median time to umbilical cord clamping was 150 and 138 s in vigorous and non-vigorous infants, respectively. Median maternal blood loss was 300 ml. CONCLUSIONS:It is feasible to provide resuscitation to term and near-term infants during DCC, after both vaginal and cesarean births, clamping the umbilical cord only when the infant is physiologically ready.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Blank DA,Badurdeen S,Omar F Kamlin C,Jacobs SE,Thio M,Dawson JA,Kane SC,Dennis AT,Polglase GR,Hooper SB,Davis PG

doi

10.1016/j.resuscitation.2018.07.020

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

1-7

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(18)30363-0

journal_volume

131

pub_type

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