Ventilation before Umbilical Cord Clamping Improves Physiological Transition at Birth or "Umbilical Cord Clamping before Ventilation is Established Destabilizes Physiological Transition at Birth".

David J R Hutchon

doi:10.3389/fped.2015.00029

Abstract

Ventilation before Umbilical Cord Clamping Improves Physiological Transition at Birth or "Umbilical Cord Clamping before Ventilation is Established Destabilizes Physiological Transition at Birth".

Highlights

Bhatt et al’s paper provides a good argument for ensuring that ventilation is established before clamping the umbilical cord (1)
He proposed that the sudden rise in cerebral circulation was the underlying mechanism for the higher incidence of intraventricular hemorrhage after early cord clamping (ECC) in preterm neonates
The simulation demonstrates that a sudden rise in cerebral pressure and blood flow is inevitable if the placental circulation is closed before the increase in pulmonary blood flow has occurred as a result of respiration

Summary

Introduction

Bhatt et al’s paper provides a good argument for ensuring that ventilation is established before clamping the umbilical cord (1). The possibility that very early clamping could explain the increased occurrence of intraventricular hemorrhage was proposed in 1988 by Hofmeyr (2) who showed that in human babies there was a marked rise in arterial pressure when the cord was clamped as late as 35 s after birth. He proposed that the sudden rise in cerebral circulation was the underlying mechanism for the higher incidence of intraventricular hemorrhage after early cord clamping (ECC) in preterm neonates.

Results

Conclusion