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Effect of placental transfusion on neonatal resuscitation attempts

Emerson, L; Laws, S (2019) Effect of placental transfusion on neonatal resuscitation attempts. Journal of Paramedic Practice, 11 (11). pp. 480-487. ISSN 1759-1376 https://doi.org/10.12968/jpar.2019.11.11.480
SGUL Authors: Laws, Samantha Anne

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Abstract

Objective: Overall, neonatal mortality has been shown to be reduced by: placental transfusion (the transfer of blood from the placenta to the neonatal circulation after birth); delayed cord clamping (DCM) (waiting for the umbilical cord to stop pulsating before clamping and cutting the cord); and umbilical cord milking (UCM) (clamping and cutting the cord immediately before milking the cord towards the neonate to expel remaining volume). This systematic review aimed to determine whether placental transfusion negatively impacts resuscitation by delaying it or has any effect on infant mortality, and to identify any barriers to performing it. Methods: CINAHL, MEDLINE, AMED and the British Nursing Index were searched using key terms to identify relevant English language publications between 2017 and 2019. Results: Five papers were selected for critical analysis—three randomised control trials and two cohort studies. Conclusion: Placental transfusion was not found to have a negative impact on neonatal resuscitation but, equally, had no significant effect on Apgar at 5 minutes; however, Apgar is a crude measure of infant mortality. The question remains around the proven multifaceted benefit of placental transfusion in the prehospital environment, which requires further research. There is evidence to suggest prehospital clinicians should be looking to change practice. Further research, considerations and consultations are required to ascertain the best way to implement the procedure with a balanced and proportionate approach considering neonatal thermoregulation and maternal management. The main reported barrier to placental transfusion was a lack of appropriate equipment.

Item Type: Article
Additional Information: This document is the Accepted Manuscript version of a Published Work that appeared in final form in Journal of Paramedic Practice, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see https://doi.org/10.12968/jpar.2019.11.11.480
Keywords: 1103 Clinical Sciences, 1117 Public Health and Health Services
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Journal or Publication Title: Journal of Paramedic Practice
ISSN: 1759-1376
Language: en
Dates:
DateEvent
2 November 2019Published
5 November 2019Published Online
1 July 2019Accepted
Publisher License: Publisher's own licence
URI: https://openaccess.sgul.ac.uk/id/eprint/114719
Publisher's version: https://doi.org/10.12968/jpar.2019.11.11.480

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