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Cord And Clamping

Arpitha Chiruvolu, Yahya Daoud, Robert W Inzer
BACKGROUND: The very preterm infants of twin births may particularly benefit from delayed cord clamping (DCC) as the likelihood of unfavorable outcome is greater compared to singletons. Unfortunately, there is paucity of available information regarding safety and efficacy of DCC in this group. OBJECTIVE: To report the clinical consequences of delayed cord clamping (DCC) in very preterm twins, born between 230/7 and 316/7 weeks gestation. STUDY DESIGN: In this pre and post intervention retrospective cohort study, we compared 30 very preterm infants born from 15 twin deliveries during historic study period to 32 very preterm infants born from 16 twin deliveries during DCC study period...
August 9, 2018: Early Human Development
Amir Kugelman, Liron Borenstein-Levin, Huda Jubran, Gil Dinur, Shlomit Ben-David, Elena Segal, Julie Haddad, Fanny Timstut, Iris Stein, Imad R Makhoul, Ori Hochwald
Iatrogenesis is more common in neonatal intensive care units (NICUs) because the infants are vulnerable and exposed to prolonged intensive care. Sixty percent of extremely low-birth-weight infants are exposed to iatrogenesis. The risk factors for iatrogenesis in NICUs include prematurity, mechanical or non-invasive ventilation, central lines, and prolonged length of stay. This led to the notion that "less is more." In the delivery room delayed cord clamping is recommended for term and preterm infants, and suction for the airways in newborns with meconium-stained fluid is not performed anymore...
July 30, 2018: Rambam Maimonides Medical Journal
Mariarosaria Di Tommaso, Silvia Vannuccini
We read with interest the Commentary "Delayed cord clamping and cord gas analysis at birth" by Xodo S et al. (1) that easily provides to the clinicians the physiological basis and the rationale for umbilical cord blood gas analysis, exploring the effect of delayed cord clamping (DCC), sampling and analysis. The final remark, considering available evidences (2-4), is to obtain umbilical cord blood for gas analysis from both the umbilical artery and umbilical vein from the pulsating cord immediately after birth and during DCC...
August 6, 2018: Acta Obstetricia et Gynecologica Scandinavica
Rasmus Kordt Christensen, Rodolfo Delgado-Lezama, Raúl E Russo, Barbara Lykke Lind, Emanuel Loeza Alcocer, Martin Fredensborg Rath, Gabriela Fabbiani, Nicole Schmitt, Martin Lauritzen, Anders Victor Petersen, Eva Meier Carlsen, Jean-François Perrier
KEY POINTS SUMMARY: GABA is an essential molecule for sensory information processing. It is usually assumed to be released by neurons. Here we show that in the dorsal horn of the spinal cord, astrocytes respond to glutamate by releasing GABA. Our findings suggest a novel role for astrocytes in somatosensory information processing. ABSTRACT: Astrocytes participate in neuronal signalling by releasing gliotransmitters in response to neurotransmitters. We investigated if astrocytes from the dorsal horn of the spinal cord of adult red-eared turtles (Trachemys scripta elegans) release GABA in response to glutamatergic receptor activation...
August 5, 2018: Journal of Physiology
Anup Katheria, Shigeharu Hosono, Walid El-Naggar
In the past five years, umbilical cord management in both term and preterm infants has come full circle, going from the vast majority of infants receiving immediate cord clamping to virtually all governing organizations promoting placental transfusion, mainly in the form of delayed cord clamping (DCC). Placental transfusion refers to the transfer of more blood components to the infant during the first few minutes after birth. The different strategies for ensuring placental transfusion to the baby include delayed (deferred) cord clamping, milking of the attached cord before clamping, and milking of the cut cord...
July 20, 2018: Seminars in Fetal & Neonatal Medicine
M Bobinac, T Ćelić, I Vukelić, J Španjol, N Rubinić, D Bobinac
Spinal cord ischemia-reperfusion injury (IRI) results in overproduction of reactive oxygen species leading to tissue oxidative stress which impacts the neuronal network in the spinal cord as well as glial cells. We investigated the expression of Nuclear factor erythroid 2-related factor 2 (Nrf2) in neurons and glial cells after occlusion of the abdominal aorta followed by IRI as well as the time-dependent expression of Nrf2 in the same cells. The experimental method of transient aortic occlusion was carried out on rats by cross-clamping of the abdominal aorta for 45 minutes...
July 2018: Journal of Biological Regulators and Homeostatic Agents
Vibhuti Shah, Kate Hodgson, Mary Seshia, Michael Dunn, Georg M Schmölzer
Objectives: To determine 'Golden Hour' resuscitation and stabilization practices for infants <32 weeks gestational age in Canadian neonatal intensive care units (NICUs). Methods: A survey was distributed to investigators of the Evidence-based Practice for Improving Quality study within the Canadian Neonatal Network in June 2014. The questionnaire was designed to obtain information on antenatal counselling, resuscitation environment, resuscitation and management practices, including respiratory and nutritional practices in the first hour of life...
July 2018: Paediatrics & Child Health
Zied Oueghlani, Cyril Simonnet, Laura Cardoit, Gilles Courtand, Jean-René Cazalets, Didier Morin, Laurent Juvin, Grégory Barrière
Control of locomotion relies on motor loops conveying modulatory signals between brainstem and spinal motor circuits. Here, we have investigated the steering control of the brainstem reticular formation over the spinal locomotor networks, using isolated brainstem-spinal cord preparations of male and female neonatal rats. First, we performed patch-clamp recordings of identified reticulospinal cells during episodes of fictive locomotion. This revealed that a spinal ascending phasic modulation of reticulospinal cell activity is already present at birth...
July 23, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Douglas A Blank, Shiraz Badurdeen, C Omar F Kamlin, Susan E Jacobs, Marta Thio, Jennifer A Dawson, Stefan C Kane, Alicia T Dennis, Graeme R Polglase, Stuart B Hooper, Peter G Davis
INTRODUCTION: Over five percent of infants born worldwide will need help breathing after birth. Delayed cord clamping (DCC) has become the standard of care for vigorous infants. DCC in non-vigorous infants is uncommon because of logistical difficulties in providing effective resuscitation during DCC. In Baby-Directed Umbilical Cord Clamping (Baby-DUCC), the umbilical cord remains patent until the infant's lungs are exchanging gases. We conducted a feasibility study of the Baby-DUCC technique...
July 20, 2018: Resuscitation
Emre Durdag, Zuhal Yildirim, Nese Lortlar Unlu, Aydemir Kale, Necdet Ceviker
OBJECTIVE: Spinal cord ischemia is a serious and catastrophic clinicopathologic condition. Despite studies reported over the last 20 years, alternative and efficient treatment options remain unclear. We examined the neuroprotective effects of vigabatrin on a spinal ischemia-reperfusion model. MATERIAL AND METHODS: We divided 24 New Zealand rabbits into four groups (control, ischemia reperfusion, and low and high dose vigabatrin). The control group underwent only abdominal surgery, while an abdominal aortic cross-clamp model of spinal ischemia was performed in the other groups...
July 19, 2018: World Neurosurgery
Abhishek Chopra, Anup Thakur, Pankaj Garg, Neelam Kler, Kanwal Gujral
BACKGROUND: Delayed cord clamping is the standard of care in infants not requiring resuscitation; however effects of cord clamping strategies have not been evaluated systematically in small for gestational age (SGA) infants. The primary objective was to compare effects of delayed cord clamping (DCC) and early cord clamping (ECC) on serum ferritin at 3 months in SGA infants born at ≥35 weeks. The secondary objectives were to compare hematological parameters, clinical outcomes in neonatal period and growth at 3 months of age...
July 18, 2018: BMC Pediatrics
J A Dawson, G M Schmölzer, J Wyllie
Resuscitation algorithms and guidelines highlight the importance of heart rate (HR) in determining interventions and assessing their effect. However, the actual HR values used are historical based upon normal physiology, and HR at birth may be affected by mode of delivery and timing of cord clamping as well as respiratory status and condition at delivery. Furthermore, the most accurate and effective ways to assess and monitor HR in the newborn infant are only now becoming established. This article examines the importance of HR values and the most widely used methods of estimation as well as some newer modalities which are being developed...
July 6, 2018: Seminars in Fetal & Neonatal Medicine
Caroline J Chantry, Aubrey Blanton, Véronique Taché, Laurel Finta, Daniel Tancredi
Background: Delayed cord clamping (DCC) results in decreased iron deficiency in infancy. The American College of Obstetrics and Gynecology has called for research on the optimal time to clamp the cord during cesarean deliveries (CD). Our objective was to conduct a pilot trial examining the safety of delayed cord clamping (DCC) for maternal-infant dyads during elective cesarean delivery (CD). Methods: We enrolled 39 dyads [23 at 90 s, 16 at 120 s; (DCC Pilot)] between 10/2013 and 9/2014...
2018: Maternal Health, Neonatology and Perinatology
Ryan M McAdams, Carl H Backes, Omid Fathi, David J R Hutchon
Delayed cord clamping, the common term used to denote placental-to-newborn transfusion at birth, is a practice now endorsed by the major governing bodies affiliated with maternal-newborn care. Despite considerable evidence, delayed cord clamping, not early cord clamping, continues to be viewed as the "experimental" intervention category when discussed in research studies. We provide a brief overview of placental-to-newborn transfusion in relation to birth transitional physiology and discuss areas where we may need to modify our interpretation of "normal" vital signs and laboratory values as delayed cord clamping becomes standardized...
2018: Maternal Health, Neonatology and Perinatology
Corinna Binder-Heschl, Kelly Crossley, Arjan Te Pas, Graeme Polglase, Douglas Blank, Valerie Zahra, Alison Moxham, Karyn Rodgers, Stuart Hooper
BACKGROUND: Caffeine is routinely given to preterm infants hours after birth to treat apnea of prematurity. In view of it's success, earlier administration in the delivery room is being considered, but little is known about how caffeine may effect the cardiovascular changes during the fetal to neonatal transition. Our aim was to determine the effect of prenatal caffeine administration on haemodynamic parameters in ventilated preterm lambs immediately after birth. METHODS: Catheters (carotid artery and jugular vein) and ultrasonic flow probes (pulmonary artery and carotid artery) were implanted in preterm lambs (~126 ±2 days of gestation; term is 147 days), immediately before delivery by caesarean section...
2018: PloS One
Andrew Weeks, Susan Bewley
No abstract text is available yet for this article.
January 1, 2018: Journal of the Royal Society of Medicine
Hyun Park, Eun-Jin Kim, Ji Hyeon Ryu, Dong Kun Lee, Seong-Geun Hong, Jaehee Han, Jongwoo Han, Dawon Kang
Tandem pore domain weak inward rectifier potassium channel (TWIK)-related spinal cord K⁺ (TRESK; K2P 18.1) channel is the only member of the two-pore domain K⁺ (K2P ) channel family that is activated by an increase in intracellular Ca2+ concentration ([Ca2+ ]i ) and linked to migraines. This study was performed to identify the effect of verapamil, which is an L-type Ca2+ channel blocker and a prophylaxis for migraines, on the TRESK channel in trigeminal ganglion (TG) neurons, as well as in a heterologous system...
July 4, 2018: International Journal of Molecular Sciences
Hamdy Awad, Anna Bratasz, Gerard Nuovo, Richard Burry, Xiaomei Meng, Hesham Kelani, Melissa Brown, Mohamed E Ramadan, Jim Williams, Lamia Bouhliqah, Phillip G Popovich, Zhen Guan, Cynthia Mcallister, Sarah E Corcoran, Brian Kaspar, D Michele Basso, José J Otero, Claudia Kirsch, Ian C Davis, Carlo Maria Croce, Jean-Jacques Michaille, Esmerina Tili
Spinal cord paralysis is relatively common after surgical repair of thoraco-abdominal aortic aneurysm (TAAA) and its etiology is unknown. The present study was designed to examine the histopathology of the disease and investigate whether miR-155 ablation would reduce spinal cord ischemic damage and delayed hindlimb paralysis induced by aortic cross-clamping (ACC) in our mouse model. The loss of locomotor function in ACC-paralyzed mice correlated with the presence of extensive gray matter damage and central cord edema, with minimal white matter histopathology...
June 18, 2018: Annals of Diagnostic Pathology
Meijia Wang, Judith S Mercer, James F Padbury
We evaluated a subset of infants with suspected intrauterine growth restriction or birth weights small for gestational age enrolled in a study of delayed cord clamping for preterm infants. Compared with immediate clamping, delayed cord clamping was associated with no apparent harm and less suspected necrotizing enterocolitis. TRIAL REGISTRATION: NCT00818220 and NCT01426698.
June 25, 2018: Journal of Pediatrics
Anna Maria Jonsson Kanold, Magnus Westgren, Cecilia Götherström
Maternal microchimerism may arise in the offspring during pregnancy, and may be favorable or unfavorable. Additionally, maternal cells present in umbilical cord blood used for stem cell transplantation may affect the outcome after transplantation. The aim of this study was to evaluate the cellular subset and frequency of maternal cells in umbilical cord blood following vaginal deliveries and elective Cesarean sections where the umbilical cord clamping time was measured. A total of 44 healthy women with normal pregnancies were included in the study...
January 1, 2018: Cell Transplantation
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