| 1954 -- Red cell and hemoglobin measurements |
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| Colozzi (1954) investigated red cell and hemoglobin values in infants with immediate cord clamping, delayed cord clamping with infant above or below the level of the uterus during the period of postnatal transfusion, and stripping. In the group subjected to immediate clamping, some of the red-cell and hemoglobin levels were thought to be alarmingly low. Postnatal transfusion with the infant held above the level of the uterus appeared comparable to that with the infant below the uterus, the reason apparently due to uterine contractions - though the infant heart may have a lot to do with regulating blood flow back to the placenta. Stripping the cord led to the highest red-cell and hemoglobin values. |
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| Although stripping the cord is not totally natural, Colozzi's concluding comments may be worth keeping in mind: |
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| "Too often, after a traumatic delivery or intrapartum bleeding episode, the physician is in great hast to clamp the cord and give a pale, listless infant to a nurse for aspiration and resuscitation. Usually, these infants are described as having asphyxia pallida, and their prognisis is grave. They respond poorly to oxygen administration, and worse to other heroic measures of resuscitation. Their main difficulty is shock and blood loss, which are inadeqately corrected by oxygen and are not improved by rough handling. I have see several infants with asphyxia pallida who were very pale and listless, with a rapid pulse and a very weak cry; with gentile, slow, methodical cord stripping, they were transformed within a few minutes to ruddy, lustily-crying infants." |
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| Also, his suggestions on finding the cord around an infant's neck during delivery, which is said to occur in 25 to 30 percent of cases: |
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| "Another situation commonly encountered is the infant with a loop or two of cord around its neck. Usually, the most expeditious measure is to clamp and cut the cord in situ. This actually amounts to immediate clamping in an already depressed baby. Every effort within reason should be made to slip the loops over the infant's head and allow it the benefit of its own blood." |
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| Colozzi's (1954) research was among many that can be called "randomized controlled trials." These continue to the present day, for what reason it is hard to fathom. If only heed were paid to the non-invasive research data that awaits rediscovery in medical journals going back over 130 years ago. Even then, research was carried out assigning groups of infants to early and some to delayed cord clamping. The major difference from such research today is the difference in what was considered early or delayed. |
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