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Early Clamping Denies Baby Blood Supply for Pulmonary Perfusion

The Best Thing You Can Do for Mothers, Babies, Birth and Families is to Become Net Savvy!

I just had my mind expanded this morning by Laureen Hudson's hour long online session on how to use the internet to get a message out. Laureen's session “Creating an Online Presence," gave me a wealth of information in a short time and impressed me with how many people are out there who completely rely on the internet for their information. I needed that, and maybe you do, too.  

  - Ina May Gaskin 

 I just hung up the phone from doing the hour long session with Laureen Hudson on “Creating an Online Presence”.  Laureen’s know-how and expertise were enough to wake up even the birth oldtimers like me and Ina May to the many unused opportunities of the internet.  Laureen’s engaging and easygoing teaching style made even those scary (to me) terms like “hypertext, streaming, wordpress, technorati, feedreader and trackback” start to make sense.  Her passion is to reach the generation of young women who have not yet given birth BEFORE they fall into the black hole of aggressive obstetrics.  I came away from the class today with lots of ways to improve my website and make it more modern, usable and interesting for readers.  This class will run again this coming Friday (August 22) and I heartily recommend it.  
- Gloria Lemay


 
REGISTER NOW! SPACE IS LIMITED! 

Cost: $35 per session 

Each session will be 60 minutes in length 

Creating An Online Presence
Sunday, September 7 at 5:00 p.m. Pacific / 8:00 p.m. Eastern
Friday, September 19 at 12:00 p.m. Pacific / 3:00 p.m. Eastern
Monday, September 22 at 9:00 a.m. Pacific / 12:00 p.m. Eastern 

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This session will include a case study of Dr. Amy and how we shoot ourselves in the collective feet by visiting and commenting on her website.  (PS Hope you enjoyed the Gotcha! page from our last email!)
Sunday, October 5 at 5:00 p.m. Pacific / 8:00 p.m. Eastern
Friday, October 24 at 12:00 p.m. Pacific / 3:00 p.m. Eastern
Monday, October 27 at 9:00 a.m. Pacific / 12:00 p.m. Eastern   

Very early clamping results in less than physiologic blood volume. The normal, term child routinely survives, but clamping the cord of a compromised child before ventilation is riskier. Initial aeration of the lungs causes reflex dilatation of pulmonary arterioles and a massive increase in pulmonary blood flow. Placental transfusion normally supplies this volume. Clamping the cord before the infant's first breath results in blood being sacrificed from other organs to establish pulmonary perfusion. Fatality may result if the child is already hypovolemic.

Because placental transfusion patterns vary widely, it is futile to attempt to give the newborn the "right" amount of blood by clamping at a set time after birth. However, it is extremely likely that the infant will have less-than-optimal blood volume if the cord is clamped before the lungs are ventilated.

In clinical practice, late clamping produces a high hematocrit, high blood pressure, and vasodilatation to accommodate the large volume of blood. These latter two factors should increase tissue perfusion. In searching the literature, I was unable to find any documented case of hyperviscosity syndrome in which the cord was clamped late, although I did find many documented cases of late clamping involving normal newborns with high hematocrits.

There are, however, many documented cases of hyperviscosity syndrome with high hematocrits (e.g., cases involving gestational diabetes or postmaturity) in which the cord was clamped before physiologic cord closure, thus creating low blood volume, low blood pressure, and vasoconstriction coupled with the polycythemia. The inadequate tissue perfusion is blamed on the high hematocrit, when the root cause of the hyperviscosity syndrome is hypovolemic vasoconstriction enforced to the fourth power.

-excerpted from George M. Morley, MB., CH. B, Cord Closure: Can Hasty Clamping Injure the Newborn? July 1998 OBG Management.



This Web page is referenced from another page containing related information about Umbilical Cord Issues

 




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