Stabilisation and Resuscitation with Optimal Management of Preterm and Term Newborns: Practical Considerations

Dear Colleagues,

The 2015 worldwide guidelines for the care of the neonate recommend that immediate cord clamping at birth be avoided and delayed for at least one minute while a physiological transition to pulmonary respiration takes place. However, if the newborn is not breathing and needs resuscitation, the advice is to clamp the cord to facilitate this. It is known that in animal models, clamping the cord before the expansion of the lungs results in a loss of cardiac return, which is only corrected after the lungs have expanded and pulmonary circulation has been established. It is recognized that this care is suboptimal, and when care of the neonate with ventilation can be provided with an intact cord, this should be chosen. However, this scenario requires preparation and, in some circumstances, modified equipment. In addition, the team need to be trained and co-ordinated in their care.

The condition of the neonate at birth also needs to be carefully determined and properly documented, ideally in real time for future auditing. Current recommendations and practices do not meet these standards.

This Special Issue will address areas that are currently preventing the widespread adoption of the resuscitation of the neonate with intact cord circulation. Vaginal birth and caesarean section may require slightly different approaches and equipment.

While there is little doubt that early cord clamping compromises the condition of the neonate, which may be critical in neonates compromised by intrapartum hypoxia, it remains to be proven that modified equipment and procedures can deliver the desired improvements in outcomes. Ideally, a randomized controlled trial is needed, but it can be argued that immediate cord clamping causes sufficient pathophysiology to render such a controlled trial unethical.

We are looking for papers describing the development and trial (at least a preliminary trial) of equipment that allows a physiological transition at birth with the cord intact and enables positive pressure ventilation of the neonate, as well as any equipment that allows the accurate measurement and documentation of the neonatal heart during transition and/or resuscitation with an intact cord.

We also welcome work on physiological transition, delayed cord clamping, motherside resuscitation, resuscitation of neonates with intact cord, measurement and documentation of neonatal heart rate at birth, and measurement and documentation of heart rate within the sterile field during caesarean section.

Dr. David Hutchon
Dr. Simone Pratesi
Dr. Ola Andersson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• neonatal transition at birth
• measurement of neonatal heart rate at birth
• management of cord at birth
• motherside neonatal resuscitation
• physiological transition
• practical needs for physiological transition