The effect of breathing on placental venous return in infants at birth: an observational study

Several studies have demonstrated a beneficial effect of delayed cord clamping
(DCC) in infants at birth and DCC is increasingly implemented in clinical
practice. These beneficial effects have been attributed to the increase of
neonatal blood volume from the placenta (placental transfusion) that occurs
during the period that the cord remains intact after birth. Although the
placental-to-infant transfusion has been described, the underlying
physiological mechanism that is responsible for this transfusion remains
unclear.

In this research study we observe the effect of breathing on placenta- to
infant transfusion, by measuring bloodflow in the umbilical vein, vena cava
inferior, ductus venosus and hepathic vein, to get a better understanding of
the underlying mechanisms and fysiology of placental transfusion. If breathing
has an effect on placenta-to infant transfusion this could lead to a better
understanding of the optimal time of cord clamping. This optimal time of cord
clamping might be after adequeate breathing has commenced.
The objective of this study is to observe the effect of breathing on the
placenta- to infant transfusion, directly after birth

Prospective, observational study

There are no know risks associated with ultrasonographic Doppler measurements
or the use of echocardiography measurements.
A possible risk could be the chance of interference between mother-child
bonding whilst obtaining ultrasonography measurements. Although this has not
been studied, we recently performed a similar study where the ultrasonography
did not interfere with the first bonding. Conform standard the infants will be
placed immediately on the mother*s chest. Also, we will only approach
multigravida mothers, to minimize the risk of interference.