Placental Transfusion as an Intrauterine Phenomenon in Deliveries Complicated by Foetal Distress

Philip, Alistair G. S.; Yee, Ann B.; Rosy, M. Marie; Surti, Nergesh; Tsamtsouris, A; Ingall, David

doi:10.1136/bmj.2.5648.11

Cited by 50 publications

(19 citation statements)

References 13 publications

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“…It seems advisable, therefore, to delay cord clamping for 1 to 1 '/2 min in premature infants, with less delay in full-term infants. If placental transfusion has occurred in utero in a fetus compromised by perinatal asphyxia, delayed clamping of the cord may be hazardous (9,12,28,48,49).…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Neonatal Plethora

Saigal

Usher²

1977

Neonatology

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Blood volume and clinical data are reported on 8 premature and 3 full-term infants who presented with symptoms apparently due to polycythemia or hypervolemia. These cases termed ‘symptomatic neonatal plethora’ were caused by large placental transfusions associated with delayed clamping of the umbilical cord. Tachypnea, mild cyanosis, plethoric skin color, and neurological depression persisted on average for 30 h after birth. Chest X-rays showed mild cardiomegaly, pulmonary congestion and edema, and pleural effusions. Although the course was in general benign, phlebotomy was considered to be indicated in three infants to treat progressive clinical deterioration. The symptomatology and blood volume on these infants were compared with infants in an ongoing study with controlled time of cord clamping. Neonatal plethora must be considered as one cause of Ê»transient tachypnea of the newborn’.

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Section: Discussionmentioning

confidence: 99%

Symptomatic Neonatal Plethora

Saigal

Usher²

1977

Neonatology

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“…The effect o f gravity has been demonstrated by others (12,13), but the role of respiration at the time of Cesarean section has not been examined previously. The possi bility of fetal distress (or asphyxia) producing a placental transfusion (8,17) was eliminated by monitoring only elective Cesarean sections, and finding no significant differences in cord pH. Both figures 1 and 2 provide evidence to indi cate that there are effects o f respiration which are independent o f gravity.…”

Section: Discussionmentioning

confidence: 66%

Role of Respiration in Effecting Placental Transfusion at Cesarean Section

Philip

Teng²

1977

Neonatology

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The transfer of blood from placenta to baby (placental transfusion) was examined in 29 full-term babies delivered by elective Cesarean Section. Events surrounding the delivery were carefully monitored using a stopwatch. Residual placental blood volume (RPBV) and change in hematocrit (Hct) were measured. In 13 infants held above the level of the placenta, the mean RPBV was significantly greater, and the change in Hct significantly lower, than in 16 infants held below the level of the placenta. Increasing duration of respiration resulted in increasing amounts of placental transfusion, even in those babies held just above the placenta. These results indicate that there are separate effects of gravity and respiration which facilitate a placental transfusion at Cesarean Section.

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“…All MEA values, how ever, are markedly lower than those ob served in pregnant women [8], placental district via vasoconstriction of the regional vessels and increased resistance. In fact, the placental blood volume is reduced in intrapartum hypoxia [11,12] and hemo globin, hematocrit and mean corpuscular volume were found to be increased in the cord blood of neonates who suffered from intrapartum hypoxia [ 13]. Also the detection of immature cells suggests that fetal erythropoiesis may be stimulated by hypoxia and may contribute to an increased fetal blood volume [14].…”

Section: Commentmentioning

confidence: 95%

Umbilical Cord Blood Rheology in Relation to Maternal Disease and Fetal Hypoxia

et al. 1989

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Erythrocyte aggregation was studied in 60 samples of cord blood taken at delivery from neonates whose mothers suffered from hypertension or diabetes in pregnancy or from neonates who showed hypoxia during labor. Eryhtrocyte aggregation significantly increased in the cord blood of neonates who suffered from hypoxia during labor, and in neonates from hypertensive and diabetic mothers. The effects of maternal disease or intrapartum hypoxia may therefore stimulate fetal erythropoiesis and cause major changes in cord blood rheology.

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Placental Transfusion as an Intrauterine Phenomenon in Deliveries Complicated by Foetal Distress

Abstract: , to all of whom I wish to express my thanks for permission to study these patients and for advice. Dr. Constance Spittle provided frequent advice on bacteriology and antibiotics.

Cited by 50 publications

References 13 publications

Symptomatic Neonatal Plethora

Symptomatic Neonatal Plethora

Role of Respiration in Effecting Placental Transfusion at Cesarean Section

Umbilical Cord Blood Rheology in Relation to Maternal Disease and Fetal Hypoxia

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