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KMID : 0377619680140030217
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Korean Jungang Medical Journal
1968 Volume.14 No. 3 p.217 ~ p.218
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Placental blood transfusion
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Ian. S. Robb
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Abstract
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Recently, many investigations have been made regarding the way in which the newborn infant changes over in a first minutes of life from a passive intrauterine existence to more active extrauterine life. Establishment of an extra-uterine circulatory system involves separating the systemic and pulmonary circulation and the obliteration of the placental circulation.
When should the cord be clamped in relation to its haemodynamic and respiratory effects on the infant, if the placental blood is transfused into the infant, in the first week of life there is a significant increase in the erythrocyte count and hemoglobin as compared to the infant in which clamping was early.
Furthermore, failure of the infant to receive its placental blood may lead to a deficiency of iron during the first year of life, and if the baby does not receive this placental blood a hypovolaemic state may ensure.
The principle of possibly a more physiological method is to extract infant and placenta together, without. cutting the cord, and then to establish an environment which allows the placental blood volume to be transfused according to the infant´s circulatory demands. This has been done Severance Hospital, Yonsei University Medical College, Department of Anesthesiology. Out of a series of 735 delivered cases from October 1966 to May 1967, it was used in 20 infants delivered by caesarian section and 30 normally delivered infants, after clamping of the umbilical cord from the moment of birth to spontaneous birth of the placenta, and it is very easy to carry out.
There seems to be no essential difference between the blood volume transfused after delivery by caesarian section and after normal vaginal delivery. In most of transfused infants this consisted about 23% of total blood volume and was 50 to 100ml. From the view point of the haemoglobin, if the infant is deprived of this placental blood there is a significant reduction of the haemoglobin as compared to infants in which clamping was delayed.
The described procedure is still experimental, and it is too early to say whether better
results are possible. A larger series has been started and we are studying, in correlation with the obstetricians, the physiology of respiratory and circulatory changes in relation to different forms of delivery.
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