2016 > 03

The first private umbilical stem cell bank has recently been established in Sweden and has started discussions regarding the ethics of saving the babys blood for the future instead of letting it keep the blood for itself. Yesterday I was interviewed in Swedish television, stressing the points:
1. That the one deciliter blood that the baby loose, is equivalent to 2 liters of blood in an adult.  
2. Our research on Swedish healthy children has shown that waiting to clamp the cord for three minutes protects against iron deficiency at four months of age and improve fine motor function at four years of age.
3. Most official statements conclude, like the American College of Obstetricians and Gynecologists: "The routine storage of umbilical cord blood as “biologic insurance” against future disease is not recommended."
Here is the Swedish TV-clip: http://www.svt.se/nyheter/lokalt/vasternorrland/insamling-av-stamceller-riskerar-barns-halsa

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Photo: bigstock.com Photo: bigstock.com

My (first ever) editorial in a scientific paper was published only some days ago in Acta Pædiatrica: http://dx.doi.org/10.1111/apa.13261

I was of course thankful and honoured by the invite and quite nervous writing it :-).
The editorial is a comment on a study published at the same time by Lamberska & al: Premature infants born at less than 25 weeks of gestation may be compromised by currently recommended resuscitation techniques

In their conclusion, Lamberska et al. suggests that sustained inflation and delayed cord clamping may be effective alternatives when it comes to reducing the high mortality and morbidity among preterm infants born at the very earliest gestational ages.

Several techniques today that provides a less invasive management of the preterm transition and adaption to extra-uterine life, but they are only slowly adopted.

There's a dilemma in medicine, between providing a safe and evidence based care, and applying new approaches and techniques in a expedient way without unnecessary delay. In my own line of research, the slow adaption of delayed cord clamping is obvious, but this has been seen in many other fields, like for example transforming from resuscitation with 100 % oxygen to room air. 

The neonatal community, both regarding research and clinical work, stands before a great challenge: in not deferring the best treatment possible to our patients unnecessary long, without tampering on safety issues.

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Photo from bigstock.com Photo from bigstock.com

Dr. Chapas ObGynPearls have published a podcast called: Delayed vs. Immediate Umbilical Cord Clamping at Delivery 

It's a comprehensive review, although a  bit outdated as it uses data extrapolated from ACOG committee opinion from December 2012.

Dr. Chapas ObGynPearls is presented as "Evidence based lessons and factual clinical pearls to accompany the Texas A&M College of Medicine ObGyn Clerkship. Dr. Hector Chapa is a Board-Certified ObGyn who has published over 40 clinical studies. Additionally, Dr. Chapa has served as an FDA clinical trial investigator for a variety of gynecological medical devices. He currently serves as Clinical Assistant Professor in the Department of Obstetrics and Gynecology for the Texas A&M College of Medicine."


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