Apgar
Oxygen
an urgent ongoing need
Transition
fetal to postnatal circulation
Tradition
Protocols
Outcomes
>>Concerns (NCS p2)
Question Authority
References
Links
Notes
Contact: Eileen Nicole Simon
eileen4brainresearch@yahoo.com
Children's Study
respiratory blood
a human invention
a long tradition
but divert the greatest volume to the placenta to receive oxygen. Once pulmonary
circulation and breathing are established, these shunts close, but they may remain open
with the newborn infant's heart continuing to pump blood through the umbilical arteries
does not cease immediately after birth, unless the cord is clamped.
subject of controversy [9-35]. The potential danger of umbilical cord clamping was
explained by Charles White in 1773, also indicating how long this controversy has gone
on. White recognized that time was required for the changeover from prenatal to
postnatal circulation, and that placental circulation should continue during this transition:
the child is born, is likewise one of those errors in practice that has
nothing to plead in its favour but custom. Can it possibly be supposed
that this important event, this great change which takes place in the lungs,
the heart, and the liver, from the state of a foetus, kept alive by the
umbilical cord, to that state when life cannot be carried on without
respiration, whereby the lungs must be fully expanded with air, and the
whole mass of blood instead of one fourth part be circulated through
them, the ductus venosus, foramen ovale, ductus arteriosus, and the
umbilical arteries and vein must all be closed, and the mode of circulation
in the principal vessels entirely altered - Is it possible that this wonderful
alteration in the human machine should be properly brought about in one
instant of time, and at the will of a by-stander?" – White 1773, p 45 [9]
(a work in progress)