Individualized Placental Transfusion Strategies for Different Newborn Categories

neonatoloji-4-4-2023

Serdar ALANa , Ümit Ayşe TANDİRCİOĞLUa

aKırıkkale University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kırıkkale, Türkiye

ABSTRACT
Placental transfusion is the transfer of placental blood to the newborn between birth and cord clamping, allowing for better regulation of the hemodynamic transition and improvement of the hemoglobin concentration and blood pressure of the newborn in the first days of life. Placental transfusion has provided significant benefits in premature infants, such as increasing the red blood cell count at birth, decreasing the need for erythrocyte transfusions, and decreasing the risk of some important premature morbidities and mortality. It also provides better iron stores in term infants without serious side effects. Delayed/deferred cord clamping or intact umbilical cord splinting/milking (I-UCM) are commonly used placental transfusion strategies in term and preterm infants. According to available data, UCM is not recommended in preterm infants below 29 weeks of gestational age due to the risk of severe intraventricular hemorrhage. Cesarean deliveries, multiple pregnancies, infants with intrauterine growth retardation, infants requiring resuscitation, infants with alloimmunization, infants of diabetic mothers and newborns with congenital heart diseases are among the exclusion criteria in many placental transfusion studies. In these high-risk situations, minimal side effects and maximum benefits may be achieved with individualized recommendations in placental transfusion practices.
Keywords: Plasental transfüzyon; bireyselleştirilme; gecikmiş kord klemplenmesi; umblikal kord sıvazlanması; prematürite

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