Umbilical cord management in neonates requiring resuscitation: controversies and challenges
10.3760/cma.j.cn113903-20250312-00116
- VernacularTitle:需复苏新生儿的脐带管理：争议与挑战
- Author:
Fan ZHANG
1
;
Laishuan WANG
Author Information
1. 江南大学附属儿童医院（无锡市儿童医院）新生儿科，无锡 214023
- Publication Type:Journal Article
- Keywords:
Infant, newborn;
Deferred cord clamping;
Umbilical cord milking;
Placental transfusion;
Resuscitation
- From:
Chinese Journal of Perinatal Medicine
2025;28(6):460-465
- CountryChina
- Language:Chinese
-
Abstract:
Umbilical cord management in neonates requiring resuscitation remains a critical yet debated topic in perinatal medicine. While deferred cord clamping (DCC) is widely adopted for non-resuscitated infants, its application during resuscitation is contentious. Emerging strategies—including physiologically-based cord clamping (PBCC), intact cord resuscitation (ICR), and umbilical cord milking (UCM)—aim to balance placental transfusion with timely resuscitation. Current evidence suggests DCC enhances blood volume and iron stores but may delay critical interventions. PBCC and ICR optimize hemodynamics by synchronizing respiration with placental transfusion, though they demand advanced technical expertise. UCM rapidly augments blood volume but raises concerns about intraventricular hemorrhage in extremely preterm infants. Further studies are needed to validate the long-term safety and efficacy of these approaches, particularly in infants <35 weeks' gestation and through combined protocol optimization. Future research should prioritize standardized guidelines to improve outcomes for neonates requiring resuscitation.
