Paeds Vivas · fetal-neonatal-and-perinatal
Transition at birth and delayed cord clamping — branching viva
Branching viva from the deferred-clamp decision for a term infant through the preterm cord plan, the milking contraindication, intact-cord resuscitation and the jaundice counselling.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
You are the neonatal registrar. A term infant has just been born vigorous. The examiner releases information in stages about cord decisions, a preterm delivery and a non-vigorous infant.
Station opening
Examiner: "A vigorous term newborn has just been delivered. Walk me through your cord management." [1]
Strong candidate (must-hit)
- Plans the cord strategy before delivery; receives the infant, dries and stimulates. [12]
- States deferred cord clamping for at least 60 seconds, skin-to-skin on the mother, cord at or below the infant. [12]
- Names the iron-store benefit as the rationale and the Cochrane evidence base. [1]
Weak candidate
- "Clamp immediately so we can weigh and examine the baby." [1]
References6ShowHide
- [1]McDonald SJ; Middleton P; Dowswell T; Morris PS Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev, 2013.PMID 23843134
- [2]Rabe H; Gyte GM; Díaz-Rossello JL; Duley L Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev, 2019.PMID 31529790
- [3]Katheria A; Reister F; Essers J; Mendler M Association of Umbilical Cord Milking vs Delayed Umbilical Cord Clamping With Death or Severe Intraventricular Hemorrhage Among Preterm Infants. JAMA, 2019.PMID 31742630
- [4]Andersson O; Hellström-Westas L; Andersson D; Domellöf M Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial. BMJ, 2011.PMID 22089242
- [12]Aziz K; Lee CHC; Escobedo MB; et al Part 5: Neonatal Resuscitation 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics, 2021.PMID 33087555
- [13]Madar J; Roehr CC; Ainsworth S; et al European Resuscitation Council Guidelines 2021: Newborn resuscitation and support of transition of infants at birth. Resuscitation, 2021.PMID 33773829