Neonatal Resuscitation With Intact Cord

Neonatal Resuscitation With Intact Cord

The purpose of this study is to examine whether providing ventilation during delayed umbilical cord clamping provides greater placental transfusion and improved hemodynamic transition at birth.

Subjects will receive 1 minute of delayed cord clamping in both arms. One arm will receive routine care, warm dry and stimulate during the 1 minutes transfusion. The second arm will receive routine care PLUS administration of CPAP and if need positive pressure ventilation. The outcome is to determine whether the addition of ventilation provides a larger placental transfusion and a smoother transition at birth.

Inclusion Criteria:

• Gestational Age: Women admitted 23+0 to 31+6 weeks (Reason: Highest risk for IVH)

Exclusion Criteria:

• Gestational Age: Parents decline consent (Reason: Can only perform intervention at time of delivery)
• Congenital anomalies of newborn (Reason: Exclude the effect of abnormal hematological function)
• Placental abruption (Reason: Exclude pregnancies at risk for hemorrhage at the time of delivery)
• Twin to twin transfusion (Reason: Exclude possible loss of blood from other twin during delayed cord clamping)
• Placenta Accreta
• Prolonged premature rupture of membranes (> 2 weeks) prior to 23 weeks gestation