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Am J Perinatol 2017; 34(02): 111-116
DOI: 10.1055/s-0036-1584521
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ventilation of Preterm Infants during Delayed Cord Clamping (VentFirst): A Pilot Study of Feasibility and Safety

Jameel Winter
1   Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
,
John Kattwinkel
1   Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
,
Christian Chisholm
2   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia
,
Amy Blackman
3   Department of Research, University of Virginia, Charlottesville, Virginia
,
Sarah Wilson
1   Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
,
Karen Fairchild
1   Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
› Author Affiliations
Further Information

Publication History

16 January 2016

06 May 2016

Publication Date:
15 June 2016 (online)

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Abstract

Background Establishing lung inflation prior to umbilical cord clamping may improve the cardiovascular transition and reduce the risk of intraventricular hemorrhage in preterm infants. We developed a pilot feasibility and safety study in which infants < 33 weeks' gestation received assisted ventilation during delayed cord clamping (DCC).

Methods Infants born between 24 0/7 and 32 6/7 weeks' gestation whose mothers consented were enrolled. All infants received continuous positive airway pressure or positive pressure ventilation during 90 seconds of DCC. Outcomes included feasibility (ability to complete protocol and maintain a sterile field during cesarean deliveries) and safety variables (Apgar scores, umbilical cord pH and base deficit, admission temperature, and postcesarean infection).

Results A total of 29 infants were enrolled, including one set of twins (median gestation: 30 weeks; 72% cesarean births). In all cases, the protocol was completed. Heart rate at 60 seconds was more than 100 beats per minute in all infants. Apgar scores, cord blood gas values, and admission temperature were comparable to other preterm deliveries at our institution.

Conclusion Assisting ventilation of very preterm infants during 90 seconds of DCC is challenging but feasible and appears to be safe in this small pilot study. A randomized clinical trial is warranted to determine clinical benefit.

Keywords

delayed cord clamping - prematurity - intraventricular hemorrhage - resuscitation
 

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