Red blood cell volume was estimated indirectly from plasma volume and venous hematocrit measurements in 262 consecutively delivered premature infants of less than 37 weeks’ gestation. Infants with respiratory distress syndrome averaged lower red cell volumes (P0.02) than those without. Fatal cases had the lowest volumes. There was a 10.3% mortality from RDS (respiratory distress syndrome) among the one third of infants with the smallest red cell volumes, and only a 2.3% mortality among the one third with the largest volumes. Red cell volume was shown to be a direct correlate of time of cord clamping and thereby of the amount of placental transfusion, both in infants with and without RDS. From this study it is probable that delayed cord clamping, by allowing placental transfusion, decreases the risk of death from RDS in premature infants. Delay in clamping the umbilical cord for 1–1.5 min is advised in premature births.
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415whose color was green between 36.3-37.1°C (normal abd. skin temp.). Below this temp, the color was brown; above, green-blue (37.2-37.9°C) or blue (>37.9°C). The crystals were fixed to black saran plastic with an adhesive undersurface which permitted fixation to the skin. 365 observations (65 infants) were made of the color of the abdominal tape compared to rectal temperature.
Tape color
BrownGreen Blue-Blue
Placental transfusion has been compared in premature and full-term infants. Blood volume measurements showed that the 5-minute transfusion was similar in full-term and premature infants (47% and 50% increase in blood volume from birth). A larger proportion of the 5-minute transfusion occurred by 1 minute in full-term (76%) than in premature infants (56%). Placental transfusion, by increasing red cell volume, greatly enhanced the severity of neonatal hyperbilirubinemia. Bilirubin concentrations of 15 mg/100 ml developed in only 6% of premature infants when cord clamping was immediate, in 14% when cord clamping was delayed 1 minute, and in 38% after a 5-minute delay in cord clamping.
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