| Observations no longer made |
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| With the now nearly universal practice of immediate cord clamping, how many doctors trained in the last two decades have ever been in attendance at what Apgar referred to as a "slow birth," waiting for pulsations of the cord to cease. We therefore need to go back to historical accounts, as in the case of vanishing diseases like smallpox, neurosyphilis, tuberculosis, leprosy, or polio. A paper by Frischkorn and Rucker (1939) paper would be as useful to include in a Cochrane Review as any of the randomized-controlled trials of "delayed cord clamping" so highly valued today. |
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| Frischkorn and Rucker provide a description of postnatal umbilical cord function, that perhaps even in the 1930s was not waited for or witnessed by many obstetricians: |
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| "If a cord be watched immediately after delivery the umbilical vessels can be seen to pulsate strongly throughout their entire length. In a varying length of time the pulsations cease in the more distal part and as this occurs the umbilical vessels collapse. This process of cessation of pulsation and collapse of the vessels proceeds toward the umbilicus until finally there is no pulsation even at the navel. The vessels are then entirely collapsed. If now the cord be tied and cut very little blood will escape from the placental end." Frishkorn & Rucker (1939), p 593. |
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