Nelle M, Zilow E P, Bastert G, Linderkamp O
Department of Pediatrics, University of Heidelberg, Germany.
Am J Perinatol. 1995 May;12(3):212-6. doi: 10.1055/s-2007-994455.
The Leboyer birth method requires that the newly born infant is placed on the mother's abdomen and the cord is clamped when it stops pulsating. This investigation was done to study the effect of Leboyer childbirth on neonatal circulation during the first 5 days after birth. Hematocrit, blood viscosity, left and right ventricular output, and cerebral blood flow velocities in the arteria carotis interna, arteria cerebri anterior, and truncus coeliacus were studied in 15 full-term neonates with early (less than 10 seconds) cord clamping and 15 full-term neonates delivered according to Leboyer (cord clamping after 3 minutes) on day 1 (2 to 4 hours after birth) and day 5. The fetal placental blood volume decreased from 42 +/- 8 mL/kg (mean +/- SD) of neonatal body weight after early cord clamping to 19 +/- 7 mL/kg after Leboyer delivery. Neonatal blood volume, calculated from the fetal placental blood volume, was 32% higher in the Leboyer group compared with the early cord-clamped infants. In the infants with early cord clamping, hematocrit, and blood viscosity did not change significantly during the first 5 days. After Leboyer birth, the hematocrit rose from 0.51 +/- 0.05 in cord blood to 0.62 +/- 0.06 at 2 to 4 hours of age, thereby increasing blood viscosity by 32%. Stroke volume, heart rate, cardiac output, left-to-right shunt across the ductus arteriosus, and blood flow velocity in the truncus coeliacus were similar in both groups and did not change during the first 5 days.(ABSTRACT TRUNCATED AT 250 WORDS)
勒博耶分娩法要求将新生儿置于母亲腹部,待脐带停止搏动后再进行结扎。本研究旨在探讨勒博耶分娩法对出生后前5天新生儿循环系统的影响。对15例足月新生儿(早结扎组,脐带结扎时间小于10秒)和15例按勒博耶法分娩的足月新生儿(脐带结扎时间为出生后3分钟)在出生第1天(出生后2至4小时)和第5天进行了研究,测定了血细胞比容、血液黏度、左右心室输出量以及颈内动脉、大脑前动脉和腹腔干的脑血流速度。早结扎组胎儿 - 胎盘血容量从出生时新生儿体重的42±8 mL/kg降至勒博耶分娩后的19±7 mL/kg。根据胎儿 - 胎盘血容量计算得出,勒博耶组新生儿血容量比早结扎组婴儿高32%。早结扎组婴儿在出生后前5天血细胞比容和血液黏度无显著变化。勒博耶分娩后,血细胞比容从脐血时的0.51±0.05升至出生后2至4小时的0.62±0.06,血液黏度相应增加32%。两组的每搏输出量、心率、心输出量、动脉导管水平的左向右分流以及腹腔干血流速度相似,且在出生后前5天均无变化。(摘要截选至250词)