Measuring cardiac changes using electrical impedance during delayed cord clamping: a feasibility trial.

Area of Science:

• Neonatal Physiology
• Perinatal Medicine
• Cardiovascular Research

Background:

• Hemodynamic changes during delayed cord clamping (DCC) in newborns have not been continuously evaluated.
• Previous studies lack continuous hemodynamic data during the critical first minutes after birth with DCC.

Purpose of the Study:

• To demonstrate the feasibility of measuring neonatal hemodynamics during DCC.
• To describe minute-by-minute hemodynamic changes in term infants undergoing DCC.

Main Methods:

• Utilized transcutaneous sensors to continuously monitor heart rate, stroke volume, and cardiac output in term infants (37-41 weeks gestation).
• Measurements were taken every beat for the first 5 minutes of life after vaginal delivery with approximately 5 minutes of DCC.
• Calculated percent change in hemodynamics from baseline for each infant.

Main Results:

• Successfully obtained reliable hemodynamic signals in all 20 enrolled infants during DCC.
• Cardiac output significantly increased from 2 to 5 minutes of life (p=0.008).
• Each minute of unclamped cord resulted in a significant increase in stroke volume (13.1% ± 12.3, p<0.0001) and cardiac output (12.6% ± 6.3, p<0.0001).

Conclusions:

• Continuous hemodynamic monitoring is feasible during DCC in newborns.
• This study provides reference values for neonatal stroke volume and cardiac output changes during the first five minutes of DCC.