David James Riddell Hutchon
Darlington Memorial Hospital, UK
Title: Motherside neonatal resuscitation with intact cord. The why and how
Biography
Biography: David James Riddell Hutchon
Abstract
Physiological transition at birth involves a range of changes in the neonatal circulation and use of the lungs as a respiratory organ for the first time. The sequence of these changes is important to maintain in resuscitation of the apnoeic neonate. The first change in physiological transition is the expansion of the lungs with air. This leads to an increase in pulmonary blood flow and all the other changes, closure of the cardiac shunts and closure of the placental circulation. Traditional clamping of the cord at birth disrupts these changes but the apnoeic neonate can maintain the sequence if ventilation is achieved with an intact cord. Mother-side resuscitation with an intact cord requires a change in delivery room practice, and co-ordination between the obstetric team and the neonatal team. Regular training and simulation of customized procedures with modified equipment can result in a seamless transition at birth for the compromised neonate.