Stabilisation of preterm infants with intact umbilical cord: feasibility study

Most preterm infants fail to aerate their immature lungs at birth and need
respiratory support for stabilisation. Cord clamping before lung aeration then
compromises cardiovascular function. Delaying cord clamping until the lung has
aerated is beneficial for preterm infants for a more stable hemodynamic
transition and also placental transfusion, for which breathing is an important
driving force. Until this was impractical to do, but a resuscitation table (the
Con-Cord table) has been designed to make it possible in preterm infants to
keep the cord intact until the lung has aerated and the infant is respiratory
stable and breathing (the Aeration Breathing Clamping (ABC) approach).

Before a large RCT can be planned with important clinical outcome we need to
test the safety and effectiveness of the new medical device (Con-Cord table)
and the ABC approach. Three consecutive studies will be performed: 1)
feasibility study, 2) effectiveness study and 3) clinical randomized trial.
This is part one of the project: the feasibility study.

To test the safety of using the Con-Cord table for stabilization of preterm
infants according to the ABC approach.

a feasibility study

Preterm infants will be stabilized on the according to the ABC approach

Using the Con-Cord table that is designed to perform the ABC approach while all
care can be provided that is similar to a standard resuscitation table and we
expect no additional burden or risk next to prematurity related risk. There is
also no extra risk to keeping the cord intact until the infant is stabilized.
There are potential benefits, but a larger RCT is needed to confirm this.