About cord clamping.
opinion article support in the latest scientific evidence.
opinion article support in the latest scientific evidence.
There
an absurd belief in the Western world, supposedly technologically and scientifically advanced, which is that the baby is born, if it is lower than the placenta the baby is filled with blood as a balloon and suffer severe polycythemia and jaundice, however if the baby is raised above the placenta the blood drained by gravity and suffer anemia. This myth has led to the modern tradition of clamping the cord immediately after birth, and consequently to seek explanations of all kinds. It seems very convenient deliveries such as "surgical" to separate the baby from the mother as soon as possible to make "Chichina."
When the baby is born, the cord is still beating just like when I was inside. If the baby was in danger before, why why now? Whether you pick up the baby or leave it down for example if the mother is squatting, your heart will continue returning the blood does not need to collect the placenta and that requires a few minutes until there is change completely and the umbilical circulation stop beating. When the cord has stopped, there is no blood flow (the cord vessels consists of smooth muscle, not a hose). Appears pale and limp, and no pulse. Again, the fact raise or lower the baby has no effect (it is a living being, not a balloon). Another factor of concern is the fact that the uterine contractions of childbirth "squeeze" the placenta so that blood back to the kid like a swollen balloon. In short, the only time I see something like that possible is that someone is squeezing the belly of the mother to stimulate contractions when not playing, or that the mother is given drugs have been administered as synthetic oxytocin in high doses or ergometrine. All these interventions increase the risk of:
- Retained placenta
- postpartum hemorrhage
- Transfusion retroplacental causing immunization against Rh positive Rh-negative mothers.
And early cord clamping the placenta is full of blood I had to go to the baby and being its larger size further increases the risk of transfusion retroplacental, retention and HPP. Some guides recommend allowing the placenta bleeding after cutting the cord to reduce these risks.
has only been described a case in which there could be a risk that the baby gets more blood than it should: at birth in water, if water is over 37.5 degrees and the placenta-cord-trinomial baby under the water can lead vasodilation. There is only one item but no investigation. Pinching is recommended at 5 minutes or drain the pool just in case. Once the water and does not cover the cord or is less than 37.5 and no risk.
When uterine contractions are spontaneous and natural delivery without interference, the placenta does not "squeeze" to the baby because at the time that reduces the size of uterine contractions through such reduce blood flow and stop the feto-placental circulation spontaneously.
If not, how the human species has survived for hundreds of thousands of years without clamps the cord? And why all mammals do not suffer from polycythemia and severe jaundice at birth if they were not clamp the cord? At what point in the evolution began to need all these interventions?
has only been described a case in which there could be a risk that the baby gets more blood than it should: at birth in water, if water is over 37.5 degrees and the placenta-cord-trinomial baby under the water can lead vasodilation. There is only one item but no investigation. Pinching is recommended at 5 minutes or drain the pool just in case. Once the water and does not cover the cord or is less than 37.5 and no risk.
When uterine contractions are spontaneous and natural delivery without interference, the placenta does not "squeeze" to the baby because at the time that reduces the size of uterine contractions through such reduce blood flow and stop the feto-placental circulation spontaneously.
If not, how the human species has survived for hundreds of thousands of years without clamps the cord? And why all mammals do not suffer from polycythemia and severe jaundice at birth if they were not clamp the cord? At what point in the evolution began to need all these interventions?
Why should stop beating the cord at birth?
Some cords stop beating immediately or within the first minute. In my personal experience is that beat 10, 15 and 20 minutes. In those cases could follow up and none of these infants had jaundice or problem. I speak of more than thirty cases of personal experience. Unfortunately it is difficult to make further studies on the subject because in most Western countries are clamped cord immediately by routine (Ceriani 2006). Infants who have suffered a bit in the process of birth and born a bit pale or cyanotic color recover quickly while beating the cord without the need to breathe or mourn for a few seconds. It is the best baby resuscitator. This cord is giving the baby the exact concentration of oxygen needed directly into the blood with which penetrates tissue faster. In contrast, in our culture to resuscitate a baby to cut the supply and force you to breathe and take in oxygen from outside, which is more traumatic for the child. (Exceptions could be: true knot of cord and abruption). The baby at birth
expects oxygenated blood cord for a few minutes, it shows in their attitude. When the baby is cutting off the supply immediately at birth (cord clamp) reacts with shock, makes a face of fear and cries shrilly, almost screaming, and not for a while. When it stops beating and not disturbed, the baby takes a few mourn, weep softer and just a little while, suddenly falls silent and looks at his mother's eyes, is calm and rosy. Of course not always the case, I'm generalizing, but I think I've had the privilege to see the difference and many people on the other hand has never seen a natural birth so that it can compare. History
Some cords stop beating immediately or within the first minute. In my personal experience is that beat 10, 15 and 20 minutes. In those cases could follow up and none of these infants had jaundice or problem. I speak of more than thirty cases of personal experience. Unfortunately it is difficult to make further studies on the subject because in most Western countries are clamped cord immediately by routine (Ceriani 2006). Infants who have suffered a bit in the process of birth and born a bit pale or cyanotic color recover quickly while beating the cord without the need to breathe or mourn for a few seconds. It is the best baby resuscitator. This cord is giving the baby the exact concentration of oxygen needed directly into the blood with which penetrates tissue faster. In contrast, in our culture to resuscitate a baby to cut the supply and force you to breathe and take in oxygen from outside, which is more traumatic for the child. (Exceptions could be: true knot of cord and abruption). The baby at birth
expects oxygenated blood cord for a few minutes, it shows in their attitude. When the baby is cutting off the supply immediately at birth (cord clamp) reacts with shock, makes a face of fear and cries shrilly, almost screaming, and not for a while. When it stops beating and not disturbed, the baby takes a few mourn, weep softer and just a little while, suddenly falls silent and looks at his mother's eyes, is calm and rosy. Of course not always the case, I'm generalizing, but I think I've had the privilege to see the difference and many people on the other hand has never seen a natural birth so that it can compare. History
:[...] In 1801, Erasmus Darwin, grandfather of Charles Darwin, cautioned against early cord clamping. He wrote, "would be very detrimental to tie the umbilical cord too soon" and insisted that was delayed until the baby had breathed repeatedly and all pulsation in the umbilical cease. [Darwin E. Zoonomia. Vol III 3rd ed. London 1801:302]
Research:
The effect of timing of cord clamping on neonatal venous hematocrit values \u200b\u200band clinical outcome at term: a randomized, controlled trial. Ceriani Cernadas JM, Carroli G, Pellegrini L, Otano L, Ferreira M, Ricci C, Casas O, Giordano D, Lardizabal J. Pediatrics. 2006 Apr; 117 (4): e779-86. Research:
CONCLUSIONS: [...] This study concludes that delayed clamping improves hematocrit physiologically and not cause any damage, reduces neonatal anemia and practice should be implemented as it is safe and increases the iron stores of newborn .
Early versus delayed cord clamping - International Journal of Childbirth Education, vol 20, no 4, December 2005, pp 16-21 Bluff L - (2005) [...] The early clamping results in hypovolemia, and as result may cause severe hypoxia. Especially in preterm infants, delayed clamping reduces the incidence of distress respiratorio, hemorragia intraventricular, enterocolitis necrotizante y lesión cerebral debido a hipoxia. También aumenta el almacenamiento de hierro previniendo anemia y problemas relacionados.
Explica que el Comparative study concluded that infants with early clamping had lower hematocrit and higher incidence of jaundice change that in cases where the cord was left beating, and was considered a positive way to ensure the baby's health, especially in countries development and Libya.
[Cord clamping at birth - Considerations for choosing the right time]. Z Geburtshilfe Perinatol Apr-May 1982, 186 (2) :59-64 This study found that babies born by caesarean section suffer a higher incidence of respiratory distress because they have not received placental transfusion, renal function also improved by having adequate blood volume. Concludes, "so the baby gets the blood it needs physiologically, the grip should be not immediately after birth but wait for the umbilical vein is empty and collapse."
Finally the WHO guidelines, we should all know very well: http://www.who.int/en/
"Late clamping (or not clamping at all) is the way Physiological of treating the cord, and early clamping is an intervention That Needs justification. "" Late clamping or not clamping is the physiological form of treating the cord, and early clamping is an intervention that requires justification. "
There's a lot more research to support these arguments, ancient and modern, but occupy an entire book. The World Health Organization based its guidelines for action in the most recent and reliable research, and in no way supports the early cord clamping.
Finally the WHO guidelines, we should all know very well: http://www.who.int/en/
"Late clamping (or not clamping at all) is the way Physiological of treating the cord, and early clamping is an intervention That Needs justification. "" Late clamping or not clamping is the physiological form of treating the cord, and early clamping is an intervention that requires justification. "
There's a lot more research to support these arguments, ancient and modern, but occupy an entire book. The World Health Organization based its guidelines for action in the most recent and reliable research, and in no way supports the early cord clamping.
Removing cord PH:
In some places, PH cord removed as a routine practice. But there are no studies that justify this practice. The PH is performed as forensic evidence to prove that baby suffered birth hypoxia or metabolic or respiratory acidosis to a greater or lesser degree, or everything was fine. However, as the thermometer does not lower the fever, the result of PH does not change the needs of the baby or the mother, and does not benefit either. If a baby is born asphyxiated, nobody is going to wait for the outcome of the PH to start CPR. If a baby is well and cries, no one will even raise the pH to fall to the ground. The results of the PH are not completely reliable either, depends on the collection, care and transport of the sample and the machine is properly calibrated. Some babies with Apgar 10.10 collecting PH of 7.1 or even 6.8, and infants with Apgar scores of 6 out of 7.35.En PH which some countries the only PH instrumental delivery is performed in or complicated for a medico-legal evidence in the face of the complaint or lawsuit. Is never done for the sake of the baby or the mother but for the staff. It is clear that WHO does not consider the removal of immediate cord pH as a necessary activity, since the priority is to stop beating the cord a few minutes. Just stop and think: if a baby is born and breathing, and alive with color, it shows immediately. What could justify that clamping the cord before you release? Definitely, take some samples for PH is not warranted.
cord blood donations:
seems that this procedure is becoming more widespread and apparently requires early cord clamping. Giving blood is the baby, as blood is going to get into your body and stops the flow to be detached and taken to a laboratory with mostly commercial purposes (obviously someone is getting rich with this new business.) One question: has anyone asked that baby legal consent to donate blood? Another question the figurative plan: imagine that the charge of taking the sample arrives late, then you could insert a cannula to remove the blood baby and then total is the same, right? I know these questions seem absurd today , but not so! Get in the baby's place (not can be so difficult, we all have been).
In some places, PH cord removed as a routine practice. But there are no studies that justify this practice. The PH is performed as forensic evidence to prove that baby suffered birth hypoxia or metabolic or respiratory acidosis to a greater or lesser degree, or everything was fine. However, as the thermometer does not lower the fever, the result of PH does not change the needs of the baby or the mother, and does not benefit either. If a baby is born asphyxiated, nobody is going to wait for the outcome of the PH to start CPR. If a baby is well and cries, no one will even raise the pH to fall to the ground. The results of the PH are not completely reliable either, depends on the collection, care and transport of the sample and the machine is properly calibrated. Some babies with Apgar 10.10 collecting PH of 7.1 or even 6.8, and infants with Apgar scores of 6 out of 7.35.En PH which some countries the only PH instrumental delivery is performed in or complicated for a medico-legal evidence in the face of the complaint or lawsuit. Is never done for the sake of the baby or the mother but for the staff. It is clear that WHO does not consider the removal of immediate cord pH as a necessary activity, since the priority is to stop beating the cord a few minutes. Just stop and think: if a baby is born and breathing, and alive with color, it shows immediately. What could justify that clamping the cord before you release? Definitely, take some samples for PH is not warranted.
cord blood donations:
seems that this procedure is becoming more widespread and apparently requires early cord clamping. Giving blood is the baby, as blood is going to get into your body and stops the flow to be detached and taken to a laboratory with mostly commercial purposes (obviously someone is getting rich with this new business.) One question: has anyone asked that baby legal consent to donate blood? Another question the figurative plan: imagine that the charge of taking the sample arrives late, then you could insert a cannula to remove the blood baby and then total is the same, right? I know these questions seem absurd today , but not so! Get in the baby's place (not can be so difficult, we all have been).
addition, practice guidelines from different countries agree that the sample is collected donated cord blood after delivery of the placenta or after the cord has stopped, to avoid affecting the health and Baby and mother:
Linden JV, Preti RA, Drack A. J Hematother. 1997 Dec; 6 (6) :535-41.
Final: Not even the donation of cord blood justifies early clamping according to research Latest scientific. It seems that the idea that "we must do many things" when a baby is born and the rush of the technocrats are the only thing that puts everyone in agreement to continue clamping the cord before hora.Espero that inspire reading my professional colleagues to improve care provided to mothers and babies with knowledge of the facts. For a generation of healthy babies and happy to be our future. Mireia
Marcos
Marcos
0 comments:
Post a Comment