Katheria A C, Lakshminrusimha S, Rabe H, McAdams R, Mercer J S
Division of Neonatology, Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA, USA.
Department of Pediatrics (Neonatology), University at Buffalo, Buffalo, NY, USA.
J Perinatol. 2017 Feb;37(2):105-111. doi: 10.1038/jp.2016.151. Epub 2016 Sep 22.
Recently there have been a number of studies and presentations on the importance of providing a placental transfusion to the newborn. Early cord clamping is an avoidable, unphysiologic intervention that prevents the natural process of placental transfusion. However, placental transfusion, although simple in concept, is affected by multiple factors, is not always straightforward to implement, and can be performed using different methods, making this basic procedure important to discuss. Here, we review three placental transfusion techniques: delayed cord clamping, intact umbilical cord milking and cut-umbilical cord milking, and the evidence in term and preterm newborns supporting this practice. We will also review several factors that influence placental transfusion, and discuss perceived risks versus benefits of this procedure. Finally, we will provide key straightforward concepts and implementation strategies to ensure that placental-to-newborn transfusion can become routine practice at any institution.
最近有许多关于给新生儿进行胎盘输血重要性的研究和报告。早断脐是一种可避免的、不符合生理的干预措施,它会阻碍胎盘输血的自然过程。然而,胎盘输血虽然概念简单,但受多种因素影响,实施起来并不总是那么直接,且可采用不同方法进行,因此探讨这一基本操作很重要。在此,我们回顾三种胎盘输血技术:延迟断脐、完整脐带挤血和剪脐挤血,以及足月儿和早产儿支持这种做法的证据。我们还将回顾影响胎盘输血的几个因素,并讨论该操作的潜在风险与益处。最后,我们将提供关键的直接明了的概念和实施策略,以确保胎盘向新生儿输血能在任何机构成为常规操作。