{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:30:58Z","timestamp":1789561858858,"version":"build-2803163510"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"07","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The authors hypothesize that particularly severely compromised and asphyctic term infants in need of resuscitation may benefit from delayed umbilical cord clamping (after several minutes).\n\t\t\t\t\tAlthough evidence is sparse, the underlying pathophysiological mechanisms support this assumption. For this review the authors have analyzed the available research. Based on these data they\n\t\t\t\t\tconclude that it may be unfavorable to immediately clamp the cord of asphyctic newborns (e.g., after shoulder dystocia) although recommended in current guidelines to provide quick\n\t\t\t\t\tneonatological support. Compression of the umbilical cord or thorax obstructs venous flow to the fetus more than arterial flow to the placenta. The fetus is consequently cut off from a\n\t\t\t\t\tsupply of oxygenated, venous blood. This may cause not only hypoxemia and consecutive hypoxia during delivery but possibly also hypovolemia. Immediate cord clamping may aggravate the\n\t\t\t\t\tsituation of the already compromised newborn, particularly if the cord is cut before the lungs are ventilated. By contrast, delayed cord clamping leads to fetoplacental transfusion of\n\t\t\t\t\toxygenated venous blood, which may buffer an existing acidosis. Furthermore, it may enhance blood volume by up to 20%, leading to higher levels of various blood components, such as red and\n\t\t\t\t\twhite blood cells, thrombocytes, mesenchymal stem cells, immunoglobulins, and iron. In addition, the resulting increase in pulmonary perfusion may compensate for an existing hypoxemia or\n\t\t\t\t\thypoxia. Early cord clamping before lung perfusion reduces the preload of the left ventricle and hinders the establishment of sufficient circulation. Animal models and clinical trials\n\t\t\t\t\tsupport this opinion. The authors raise the question whether it would be better to resuscitate compromised newborns with intact umbilical cords. Obstetric and neonatal teams need to work\n\t\t\t\t\teven closer together to improve neonatal outcomes.<\/jats:p>","DOI":"10.1055\/a-1804-3268","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T22:58:28Z","timestamp":1656025108000},"page":"706-718","source":"Crossref","is-referenced-by-count":4,"title":["Resuscitation of Term Compromised and Asphyctic Newborns: Better with Intact Umbilical Cord?"],"prefix":"10.1055","volume":"82","author":[{"given":"Friederike","family":"Ott","sequence":"additional","affiliation":[{"name":"Frauenkliniken der Asklepios Kliniken Barmbek, Wandsbek und Nord-Heidberg, Hamburg, Germany"},{"name":"Asklepios Medical School, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Kribs","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Neonatologie und p\u00e4diatrische Intensivmedizin, Universit\u00e4tskinderklinik, K\u00f6ln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Stelzl","sequence":"additional","affiliation":[{"name":"Frauenklinik, Kepler Universit\u00e4tsklinikum Linz, Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Kyvernitakis","sequence":"additional","affiliation":[{"name":"Frauenkliniken der Asklepios Kliniken Barmbek, Wandsbek und Nord-Heidberg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ehlen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kinder- und Jugendmedizin, Marienhaus Klinikum Bendorf \u2013 Neuwied \u2013 Waldbreitbach, Neuwied, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Schmidtke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Neonatologie und p\u00e4diatrische Intensivmedizin, Asklepios Kliniken Barmbek und Nord-Heidberg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamina","family":"Rawnaq-M\u00f6llers","sequence":"additional","affiliation":[{"name":"Frauenkliniken der Asklepios Kliniken Barmbek, Wandsbek und Nord-Heidberg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Rath","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsfrauenklinik, Universit\u00e4tsklinikum Schleswig Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Berger","sequence":"additional","affiliation":[{"name":"Frauenklinik, Marienhaus Klinikum Neuwied, Neuwied, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Maul","sequence":"additional","affiliation":[{"name":"Frauenkliniken der Asklepios Kliniken Barmbek, Wandsbek und Nord-Heidberg, Hamburg, Germany"},{"name":"Asklepios Medical School, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"ref2","first-page":"409","article-title":"No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths","volume":"83","author":"J Lawn","year":"2005","journal-title":"Bull World Health Organ"},{"issue":"S 01","key":"ref3","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/pr.2013.206","article-title":"Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990","volume":"74","author":"A C Lee","year":"2013","journal-title":"Pediatr Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1007\/s12098-013-1328-9","article-title":"Systemic effects of perinatal asphyxia","volume":"81","author":"A Bhatti","year":"2014","journal-title":"Indian J 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Yao","year":"1969","journal-title":"Lancet"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"473","DOI":"10.3389\/fped.2019.00473","article-title":"Placental Transfusion for Asphyxiated Infants","volume":"7","author":"A C Katheria","year":"2019","journal-title":"Front Pediatr"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"S516","DOI":"10.1161\/CIRCULATIONAHA.110.971127","article-title":"Part 11: Neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations","volume":"122 (16 Suppl.\u20092)","author":"J M Perlman","year":"2010","journal-title":"Circulation"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"F355","DOI":"10.1136\/archdischild-2013-305703","article-title":"A physiological approach to the timing of umbilical cord clamping at birth","volume":"100","author":"S B Hooper","year":"2015","journal-title":"Arch Dis Child Fetal Neonatal 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