Mohan

We are frequently using this practice all over India with good results

Great job. Is this similar to the Life start trolley being used in UK?

Outcome depends on cause. Just had a a preterm baby with sclerema due to hypothermia. He has recovered with appropriate treatment

Thanks

Any insights into my questions. At least let us know the practice you all are following

Kindly attached a photograph of baby on Mira Cradle in our hospital

Just a thought. Since these solutions(3% saline and Sod Bicarb) are hyperosmolar can they increase the risk of NNEC

We talk to the Obstetrician before delivery and find out if there are no contraindication for DCC. If so we plan for 3 minutes for DCC in term babies. For a vaginal delivery after delivery the baby is placed on the mother's abdomen and covered and monitored. Sometimes the placenta is delivered before 3 minutes and presently we are cutting the cord then though this is controversial. If for some reason the cord has to be cut early then only milking is done. For LSCS we keep the baby on the OT table and follow the same procedure. All attending Pediatricians in our hospital are aware of the contraindications and follow it. In fact in our delivery notes we have made a column for DCC time and reasons for not doing DCC which they fill up. For preterms we do DCC for 1 minute and strictly no milking

I am practicing on an exclusive mother and child care hospital in a resource poor setting in Western Odisha India where we get a lot of babies with birth asphyxia. For the last 4 yrs we have been using a low cost device called Mira Cradle which uses phase change material in a a polyurethane cradle. We have found it to be very effective in maintaining the requisite temperature for 72 hrs without use of electricity. This has resulted in favorable out comes especially in babies with moderate encephalopathy

Dear Rianne, Thanks a lot for the interesting insight into DCC and the referenced article. I do agree the placental blood volume will be helpful to the neonate. But how will blood flow into the neonate after the placenta has been delivered? One study suggested that the placenta be collected in a sterile bag(if delivered before 3 minutes) and taken along with the baby. If so where will the placenta be kept? On the same matress as the baby or should it be suspended at a higher level for gravity to allow the placental blood to flow into the neonate? Any studies on this and the practical methods of doing this? Mohan

Thanks satyen for clarifying

Is there any point in delaying clamping the cord after the placenta has been delivered which sometimes happens before 3 minutes, the time recommended for term babies in the webnar Also neither AAP nor WHO or Gynecological societies mention 3 minutes as the recommended time as yet. So can there be medico legal issues

Is there any point in doing DCC after the placenta has been separated and delivered

Can we diagnose PPHN fairly confidently by this procedure to start Sidenafil

Thought provoking article. In my practice we often discharge babies on caffeine and continue till at least 38 weeks PMA