Placental transfusion: a review

Katheria, Anup; Lakshminrusimha, Satyanarayana; Rabe, Heike; McAdams, Ryan M.; Mercer, Judith S.

doi:10.1038/jp.2016.151

Cited by 150 publications

(141 citation statements)

References 64 publications

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“…While there remain theoretic concerns regarding overtransfusion, polycythemia, hyperbilirubinemia, and delayed resuscitation when implementing any placental transfusion technique, these concerns have not been substantiated in any systematic reviews of short-term outcomes or in studies of neurodevelopmental follow-up. 10,[27][28][29][30] Existing studies of delayed cord clamping and umbilical cord milking have largely been performed in singleton pregnancies, and effectiveness in multiple gestations is unknown. Because of the relatively higher rates of morbidity and mortality in multiple gestations, we hypothesize that the benefit of placental transfusion may be magnified in this population.…”

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confidence: 99%

Neonatal Outcomes Associated with Umbilical Cord Milking in Preterm Multiple Gestations

et al. 2019

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Objective Our aim was to evaluate the effect of umbilical cord milking on outcomes for preterm multiples. Study Design We implemented a policy of cord milking in neonates born at less than 30 weeks' gestation in September 2011. We compared cord milking in multiples with a historical cohort. Multivariable logistic regression models estimated the effect of cord milking on a composite neonatal adverse outcome. Secondary outcomes were hematocrit at birth, need for blood transfusion, and inotrope use. Results We identified 149 neonates (120 twins, 29 triplets), 51 historical controls, and 98 neonates with cord milking. Cord milking was associated with a lower rate of adverse composite neonatal outcome in univariable analysis (odds ratio [OR]: 0.36; 95% confidence interval [CI]: 0.15–0.84). However, in multivariable modeling, the effect was not significant (adjusted OR [aOR]: 0.54, 95% CI: 0.23–1.28). Hematocrit was 4.6 unit % (95% CI: 2–7.3) higher in the cord milking group, and cord milking was associated with a lower rate of blood transfusion (aOR: 0.28; 95% CI: 0.1–0.74; p = 0.01). There was no difference in inotrope administration. Conclusion Umbilical cord milking was not associated with a decrease in composite neonatal adverse outcome. However, we observed an increase in hematocrit and decreased need for blood transfusion in neonates with cord milking.

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confidence: 99%

Neonatal Outcomes Associated with Umbilical Cord Milking in Preterm Multiple Gestations

et al. 2019

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“…Subsequent publications have mostly re-demonstrated similar findings, albeit with differences in certain morbidities and mortality [41]. The theoretical risks of DCC include volume overload and polycythemia, resulting in hyperbilirubinemia, but these risks have yet to be demonstrated in the literature [42].…”

Section: Delayed Cord Clampingmentioning

confidence: 94%

Golden Hours: An Approach to Postnatal Stabilization and Improving Outcomes

Fathi¹,

Bapat²,

Shepherd³

et al. 2019

Neonatal Medicine

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The "Golden Hour" model of care originated in adult trauma medicine. Recently, this concept has been applied to premature neonates and the care they receive immediately after birth. This is not limited to the first hour of life, however, as this approach encompasses the first hours and days after birth. While no universal description defines the Golden Hour model, critical domains include initial delivery room management, thermoregulation, ventilation and oxygenation, glycemic control and prevention of infection. Strong evidence favors standardization of care to improve short-and long-term outcomes. This approach to care for the most at-risk premature infant is typically institution-specific; thus, team-building and quality improvement are critical to the care of these vulnerable patients.

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“…Erfolgt das Abnabeln nicht unmittelbar nach der Geburt, sondern verzögert, erhält das Kind eine gewisse Menge an autologem Blut, das sich in Plazenta und Nabelschnur befindet, transfundiert. Rasches Abnabeln lässt sich auch bei reifen Neugeborenen als eine vermeidbare, unphysiologische Intervention betrachten, bei der der natürliche Prozess einer plazentaren Transfusion während der postnatalen Transition unterbunden wird [23]. Nach der Dokumentation der Befunde formulieren Sie Ihre Empfehlungen für die weitere Betreuung.…”

Section: Abnabelnunclassified