ArticleMaternal health, neonatology and perinatology2019
Transitional fetal hemodynamics and gas exchange in premature postpartum adaptation: immediate vs. delayed cord clamping.
Article in Maternal health, neonatology and perinatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Comparative efficacy of volume expansion, inotropes and vasopressors in preterm neonates with probable transitional circulatory instability in the first week of life: a systematic review and network meta-analysis.BMJ paediatrics open · 2024Pooled it
- Computer-generated Clinical Decision-making in the Treatment of Pulmonary Atresia with Intact Ventricular Septum.Cardiovascular engineering and technology · 2025Article
- A Multiscale Mathematical Model for Fetal Gas Transport and Regulatory Systems During Second Half of Pregnancy.International journal for numerical methods in biomedical engineering · 2025Article
- A Multiscale Mathematical Model for the Fetal Blood Circulation of the Second Half of Pregnancy.International journal for numerical methods in biomedical engineering · 2024Article
- Switching the Left and the Right Hearts: A Novel Bi-ventricle Mechanical Support Strategy with Spared Native Single-Ventricle.Annals of biomedical engineering · 2023Article
- Article
- Effect of delayed cord clamping on maternal and neonatal outcome in twin pregnancies: a retrospective cohort study.Scientific reports · 2023Article
- Recasting Current Knowledge of Human Fetal Circulation: The Importance of Computational Models.Journal of cardiovascular development and disease · 2023Review
- Placental transfusion during neonatal resuscitation in an asphyxiated preterm model.Pediatric research · 2022Article
- Hemodynamic Quality Improvement Bundle to Reduce the Use of Inotropes in Extreme Preterm Neonates.Paediatric drugs · 2022Article
- A review study of fetal circulatory models to develop a digital twin of a fetus in a perinatal life support system.Frontiers in pediatrics · 2022Review
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent studies suggest that delayed cord clamping (DCC) is advantageous for achieving hemodynamic stability and improving oxygenation compared to the immediate cord clamping (ICC) during fetal-to-neonatal transition yet there is no quantitative information on hemodynamics and respiration, particularly for pre-term babies and fetal disease states. Therefore, the objective of this study is to investigate the effects of ICC and DCC on hemodynamics and respiration of the newborn preterm infants in the presence of common vascular pathologies.
methodsA computational lumped parameter model (LPM) of the placental and respiratory system of a fetus is developed to predict blood pressure, flow rates and oxygen saturation. Cardiovascular system at different gestational ages (GA) are modeled using scaling relations governing fetal growth with the LPM. Intrauterine growth restriction (GR), patent ductus arteriosus (PDA) and respiratory distress syndrome (RDS) were modeled for a newborn at 30 weeks GA. We also formulated a "severity index (
resultsOur results show that transitional hemodynamics is smoother in DCC compared to ICC for all GAs. Blood volume of the neonate increases by 10% for moderately preterm and term infants (32-40 wks) and by 15% for very and extremely preterm infants (22-30 wks) with DCC compared to ICC. DCC also improves the cardiac output and the arterial blood pressure by 17% in term (36-40 wks), by 18% in moderately preterm (32-36 wks), by 21% in very preterm (28-32 wks) and by 24% in extremely preterm (20-28 wks) births compared to the ICC. A decline in oxygen saturation is observed in ICC received infants by 20% compared to the DCC received ones. At 30 weeks GA, SI were calculated for healthy newborns (1.18), and newborns with GR (1.38), PDA (1.22) and RDS (1.2) templates.
conclusionOur results suggest that DCC provides superior hemodynamics and respiration at birth compared to ICC. This information will help preventing the complications associated with poor oxygenation arising in premature births and pre-screening the more critical babies in terms of their cardiovascular severity.
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