The issue of timing of cord clamping at birth is presented in depth in this book. Physiologic literature is reviewed and errors and limitations in technique are presented and discussed. The authors begin with an adequate discussion of methods and limitations of technique and proceed to an in-depth discussion of mechanism of placental transfusion.
In logical sequence, the authors then describe neonatal blood volume adjustments in the first hours of life. The impact of placental transfusion of varying volumes of blood on neonatal homeostasis are described in detail, including respiratory adaptation and hyperbilirubinemia.
Placental transfusion and perinatal complications are described, including cesarean birth, perinatal asphyxia, diabetes mellitus, and Rh hemolytic disease. The text concludes with physiologically based recommendations regarding the timing of umbilical cord clamping at birth. In uncomplicated births, cord clamping at 10 to 30 s after the delivery of the infant's buttocks, with the infant 10 cm below