Obstetrics: Cutting the Cord Too Soon

Obstetrics: Cutting the Cord Too Soon

The lungs of most newborn infants begin
to work exactly on schedule. But among some babies, particularly the
premature, the lungs fail to expand properly. The chest sags, breathing
is rapid and the child turns blue. Many deaths during the first week
after birth are attributable to this condition, which doctors describe
as the “respiratory distress syndrome.”Obstetricians have long noted that babies suffering from such troubles
either were delivered by Caesarean section, or were premature infants,
or born of diabetic mothers. But in the A.M.A. Journal, a group of
pediatricians* from the University of California suggests that the most
important factor is the time at which the obstetrician clamps and cuts
the infant's umbilical cord.The California pediatricians base their theory on a study of 129
infants. Among 41 whose umbilical cords were clamped before they took
their second breath, 21 showed moderate to severe respiratory distress.
In another group of 52 infants whose umbilicals had been clamped some
time after the second breath, only six suffered the same symptoms. The
condition of the infants who retained their umbilical cords longest was
by far the best.There are sound reasons, say the doctors, for a slowdown in cutting the
umbilical cord. Delay allows a gradual change from fetal to regular
circulation without putting stress on blood vessels in the lungs and
elsewhere in the body. The carefree manner in which the newly born
infant is “disconnected” from his mother, concludes the report, “is in
sharp contrast to the meticulous care with which the thoracic surgeon
separates his patient from the heart-lung machine.”* Drs. Arthur J. Moss, Edward Duffle Jr. and Leonard M. Pagan
of Los Angeles.

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