Neonatal Resuscitation at Birth with Intact Placental Circulation*Corresponding Author: David J R Hutchon, Memorial Hospital, Darlington, UK, Tel: +441325253278, Email: [email protected]
Received Date: May 28, 2020 / Accepted Date: Jun 08, 2020 / Published Date: Jun 14, 2020
Citation: David J R Hutchon (2020) Neonatal Resuscitation at Birth with Intact Placental Circulation. Neonat Pediatr Med 6: 192.
Copyright: © 2020 Hutchon DJR. This is an open-access article distributed under the terms of the creative commons attribution license which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Neonatal asphyxia at birth is a major cause of mortality and long term disability. However the clinical diagnosis is imprecise and largely subjective. At the moment of birth it is usually the obstetrician or midwife who has to make the diagnosis within the first 60 seconds. Logically positive pressure ventilation is the treatment of the apneic neonate but in order for this to be carried out on the roomside resuscitation trolley, another intervention, the intervention of cord clamping is required. Cord clamping is therefore performed, by definition, before neonatal breathing is established, and it is now known that clamping the cord at this stage shocks the cardiovascular system. The shock of early cord clamping results in bradycardia, hypoxaemia, hypovolemia, reduced cerebral circulation and reduced muscular tone, and reduced activity of the respiratory centre. Permanent injury and long term disability is possible if these adverse factors cannot be reversed quickly during resuscitation after birth. Being prepared for and then providing effective ventilation close to the mother with an intact cord can prevent all these adverse events and also initiate a physiological transition from placental to pulmonary respiration.