Abstract
The current recommendation for umbilical cord management of non-vigorous infants (limp, pale, and not breathing) who need resuscitation at birth is to immediately clamp the umbilical cord. This recommendation is due in part to insufficient evidence for delayed cord clamping (DCC) or umbilical cord milking (UCM). These methods may provide a neuroprotective mechanism that also facilitates cardiovascular transition for non-vigorous infants at birth.
Highlights
An estimated one million newborns worldwide suffer from perinatal asphyxia which lead them to being at risk for developing hypoxic-ischemic encephalopathy (HIE) due to inadequate blood flow and oxygen delivery to the neonatal brain and other vital organs such as the heart and kidneys
The current recommendation for umbilical cord management of infants who are depressed and need resuscitation at birth is to immediately clamp the umbilical cord. This recommendation is due in part to insufficient evidence to support delayed cord clamping (DCC) or umbilical cord milking (UCM) in the presence of perinatal distress [12]
When the cord is cut rapidly, the infant has no access to approximately 30 mL/kg of blood—about 30 percent of the fetalplacental blood volume in a term neonate [26]—resulting in essential hypovolemia when the lungs are first aerated after early cord clamping (ECC) (Figure 3)
Summary
The current recommendation for umbilical cord management of non-vigorous infants (limp, pale, and not breathing) who need resuscitation at birth is to immediately clamp the umbilical cord. This recommendation is due in part to insufficient evidence for delayed cord clamping (DCC) or umbilical cord milking (UCM). These methods may provide a neuroprotective mechanism that facilitates cardiovascular transition for non-vigorous infants at birth. Specialty section: This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics
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