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Making the Argument for Intact Cord Resuscitation a case.pdf (2.17 MB)

Making the argument for intact cord resuscitation: a case report and discussion

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posted on 2023-06-10, 03:06 authored by Judith Mercer, Debra Erickson-Owens, Heike RabeHeike Rabe, Karen Jefferson, Ola Andersson
We use a case of intact cord resuscitation to argue for the beneficial effects of an enhanced blood volume from placental transfusion for newborns needing resuscitation. We propose that intact cord resuscitation supports the process of physiologic neonatal transition, especially for many of those newborns appearing moribund. Transfer of the residual blood in the placenta provides the neonate with valuable access to otherwise lost blood volume while changing from placental respiration to breathing air. Our hypothesis is that the enhanced blood flow from placental transfusion initiates mechanical and chemical forces that directly, and indirectly through the vagus nerve, cause vasodilatation in the lung. Pulmonary vascular resistance is thereby reduced and facilitates the important increased entry of blood into the alveolar capillaries before breathing commences. In the presented case, enhanced perfusion to the brain by way of an intact cord likely led to regained consciousness, initiation of breathing, and return of tone and reflexes minutes after birth. Paramount to our hypothesis is the importance of keeping the umbilical cord circulation intact during the first several minutes of life to accommodate physiologic neonatal transition for all newborns and especially for those most compromised infants.

History

Publication status

  • Published

File Version

  • Published version

Journal

Children

ISSN

2227-9067

Publisher

MDPI

Issue

4

Volume

9

Page range

1-13

Article number

a517

Department affiliated with

  • Clinical and Experimental Medicine Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2022-04-08

First Open Access (FOA) Date

2022-04-08

First Compliant Deposit (FCD) Date

2022-04-08

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