(Press-News.org) This news release is available in Spanish.
A technique to increase the flow of blood from the umbilical cord into the infant's circulatory system improves blood pressure and red blood cell levels in preterm infants delivered by Cesarean section, according to a study funded by the National Institutes of Health.
The study, published online in Pediatrics, was conducted by researchers at the Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns in San Diego, and Loma Linda University, Loma Linda, Calif. It was supported by NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
The technique, known as cord milking, consists of encircling the cord with thumb and forefingers, gently squeezing, and slowly pushing the blood through the cord to the infant's abdomen. For infants delivered by cesarean, cord milking appears to offer benefits over the standard practice of waiting 45 to 60 seconds before clamping and then cutting the umbilical cord. These benefits, which include greater blood flow to and from the heart, higher red blood cell level, and higher blood pressure, were seen only in the infants delivered by Cesarean. Among a smaller number of vaginal births, the researchers found no difference in blood volume between infants undergoing cord milking and those undergoing delayed cord clamping.
"The study results are very encouraging," said Tonse Raju, M.D., chief of NICHD's Pregnancy and Perinatology Branch. "The findings need to be confirmed in a larger number of births, but at this point, it appears that umbilical cord milking may prove to be of great benefit to preterm infants delivered via Cesarean."
The study authors note that in 2012, the American College of Obstetricians and Gynecologists recommended a 30 to 60-second delay before clamping the umbilical cord in all preterm deliveries. The organization has not made a recommendation on when to clamp the umbilical cord in term births, and so physicians typically use their best judgement on the timing of cord clamping in term infants.
Delaying umbilical cord clamping by 30 to 60 seconds is thought to allow sufficient time for blood from the umbilical cord to fill the blood vessels in the infant's lungs, Raju explained in an earlier podcast. Among preterm infants, the delay is believed to protect from intraventricular hemorrhage, or bleeding in the ventricles -- the cavities inside the infant's brain. The hemorrhage is thought to result from low blood pressure, brought on by having too little blood in the circulatory system. Bleeding in the brain may result in developmental delays, cerebral palsy, and in severe cases, death.
However, Dr. Anup C. Katheria, M.D., a neonatologist at the Neonatal Research Institute at the Sharp Mary Birch Hospital and the study's first author, noted that some studies failed to find a reduction in intraventricular hemorrhage from delayed cord clamping among preterm infants delivered by Cesarean. The scientists theorized that the use of an anesthetic in Cesarean delivery reduces uterine contractions, and in so doing hinders the exodus of blood from the umbilical cord. Cord milking, they reasoned, might compensate for diminished blood flow through the umbilical cord and increase the amount of blood available to the infant.
The researchers enrolled 197 infants in their study. Mothers went into labor at or before the 32nd week of pregnancy. Of these, 154 were delivered by Cesarean, with 75 assigned at random to the umbilical cord milking group and 79 assigned to the delayed clamping group. The 43 infants delivered vaginally also were assigned at random to either delayed clamping or umbilical cord milking.
Of the infants undergoing Cesarean deliveries, those in the cord milking group had higher blood flow in the superior vena cava, the large vein carrying blood from the brain to the heart, and a higher output of blood from the right ventricle. The two measures, taken together, are an indication of blood circulation in the brain and body. Infants in the cord milking group also had higher blood pressure and higher levels of hemoglobin -- a protein used as an indicator of the quantity of red blood cells.
Among the smaller number of infants that were delivered vaginally, the researchers found no differences in the blood volume or blood pressure between the two groups.
INFORMATION:
About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the institute's website at http://www.nichd.nih.gov/.
About the National Institutes of Health (NIH)
NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.
Boston, MA -- Longer secondary schooling substantially reduces the risk of HIV infection--especially for girls--and could be a very cost-effective way to halt the spread of the virus, according to researchers from Harvard T.H. Chan School of Public Health. In a study in Botswana, researchers found that, for each additional year of secondary school, students lowered their risk of HIV infection by 8 percentage points about a decade later, from 25% to about 17% infected.
"These findings confirm what has been fiercely debated for more than two decades--that secondary schooling ...
Longer secondary schooling substantially reduces the risk of contracting HIV, particularly for girls, according to new research from Botswana published in The Lancet Global Health journal. The researchers estimate that pupils who stayed in school for an extra year of secondary school had an 8 percentage point lower risk of HIV infection about a decade later, from about 25% to about 17% infected.
The study, which also shows expanding secondary schooling to be a very cost effective HIV prevention measure, used a recent school policy reform as a 'natural experiment' to ...
The day will officially be a bit longer than usual on Tuesday, June 30, 2015, because an extra second, or "leap" second, will be added.
"Earth's rotation is gradually slowing down a bit, so leap seconds are a way to account for that," said Daniel MacMillan of NASA's Goddard Space Flight Center in Greenbelt, Md.
Strictly speaking, a day lasts 86,400 seconds. That is the case, according to the time standard that people use in their daily lives -- Coordinated Universal Time, or UTC. UTC is "atomic time" -- the duration of one second is based on extremely predictable electromagnetic ...
City College of New York researchers led by chemist George John have developed an eco-friendly biodegradable green "herding" agent that can be used to clean up light crude oil spills on water.
Derived from the plant-based small molecule phytol abundant in the marine environment, the new substance would potentially replace chemical herders currently in use. According to John, professor of chemistry in City College's Division of Science, "the best known chemical herders are chemically stable, non-biodegradable, and hence remain in the marine ecosystem for years."
"Our ...
SACRAMENTO, Calif. -- Low flu vaccination rates, medication compliance and limited access to primary care providers have contributed to the high pediatric asthma rates in California, say UC Davis pediatricians Ulfat Shaikh and Robert Byrd, who have published an extensive study describing the challenges faced by children with asthma in California.
Analyzing data from the 2011-12 California Health Interview Survey, the study details several issues affecting asthma care and offers a number of public policy strategies that could help remedy these shortcomings. The research ...
Research led by Michigan State University could someday lead to the development of new and improved semiconductors.
In a paper published in the journal Science Advances, the scientists detailed how they developed a method to change the electronic properties of materials in a way that will more easily allow an electrical current to pass through.
The electrical properties of semiconductors depend on the nature of trace impurities, known as dopants, which when added appropriately to the material will allow for the designing of more efficient solid-state electronics.
The ...
Athens, Ga. -- Despite heavy development, the U.S. still has millions of acres of pristine wild lands. Coveted for their beauty, these wilderness areas draw innumerable outdoor enthusiasts eager for a taste of primitive nature.
But University of Georgia researchers say these federally protected nature areas have a problem: Their boundaries have become prime real estate.
As the country's population continues to grow, people have built homes close to national parks, forests and wilderness areas for the same reasons these systems have been left protected from development. ...
Baltimore, June 26 -- The flu virus can be lethal. But what is often just as dangerous is the body's own reaction to the invader. This immune response consists of an inflammatory attack, meant to kill the virus. But if it gets too aggressive, this counterattack can end up harming the body's own tissues, causing damage that can lead to death.
Now, a University of Maryland School of Medicine (UM SOM) researcher has for the first time uncovered new details about how this response plays out. Furthermore, he has identified a "decoy" molecule that can rein in this runaway inflammatory ...
When the new iPhone came out, customers complained that it could be bent -- but what if you could roll up your too big 6 Plus to actually fit in your pocket? That technology might be available sooner than you think, based on the work of USC Viterbi engineers.
For many decades, silicon has been the heart of modern electronics -- but as a material, it has its limits. As our devices get smaller and smaller, the basic unit of these devices, a transistor, must also get tinier and tinier. Bottom line: the size of the silicon transistor is reaching its physical limit. As silicon ...
Toxic environmental contaminants are increasingly known to cause a number of severe health problems, in particular on fetuses, including heart failure, low cognitive ability, delayed development, and neurobehavioral disorders.
A new research featured in the Environmental Science and Technology published by the American Chemical Society suggests that the fetus is more vulnerable to some pollutants with certain properties because they penetrate further into the feto-maternal system. The research found that distributions of pollutants and the mechanisms of distributions ...
