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Death of cesarean infants: a theory as to its cause and a method of prevention
SHALEV ET AL
THE JOURNAL OF PEDIATRICS VOLUME 136, NUMBER 4 Greenberg CR, Bishop AJ. A variant congenital dyserythropoietic anemia presenting as a fatal hydrops foetalis. Br J Haematol 1990;76:438-9. 7. Cantu-Rajnoldi A, Zanella A, Conter U, Faccini P, Soligo D, Gornati G, et al. A severe transfusion-dependent congenital dyserythropoietic anaemia presenting as hydrops fetalis. Br J Haematol 1997;96:530-3. 8. Jijina F, Ghosh K, Yavagal D, Pathare AV, Mohanty D. A patient with con-
genital dyserythropoietic anemia type III presenting with stillbirth. Acta Haematol 1998;99:31-3. 9. Gersony WM. Neonatal pulmonary hypertension: pathophysiology, classification and etiology. Clin Perinatol 1984;11:517-24. 10. Fricker HS, Zumofen W, Hofmann E. Severe neonatal anemia associated with fetomaternal transfusion and persistent fetal circulation. Helv Paediatr Acta 1983;38:179-83.
11. Roberts JD, Polaner MD, Lang P, Zapol WM. Inhaled nitric oxide in persistent pulmonary hypertension of the newborn. Lancet 1992;340: 818-9. 12. Tchernia G, Dommergues M, Zupan V, Chambost H, Wickramasighe SN, Bader-Meunier B. Severe congenital dyserythropoietic anemia type I. Antenatal management, transfusion support, and interferon α therapy. [Abstract] Pediatr Res 1999;45:759.
50 Years Ago in The Journal of Pediatrics DEATH OF CESAREAN INFANTS: A THEORY AS TO ITS CAUSE AND A METHOD OF PREVENTION Landau DB, Goodrich HB, Francka WF, Burns FR. J Pediatr 1950;36:421-6 In 1950 Landau and associates reported that infants born by cesarean section often died of asphyxia, an outcome that could be decreased by the spontaneous onset of labor before cesarean section. They further noted that the infants develop “cyanosis, respiratory distress with dyspnea, air hunger, and costal retractions with rapid weak pulse” within hours. They proposed that the major problem was shock resulting from cord clamping immediately after delivery. They reported their favorable experience with a delayed cord clamping procedure, designed to increase the intravascular volume of infants delivered by cesarean section. They then said that they could not justify a controlled trial because their results were so good. In hindsight, their physiology was correct: infants delivered by cesarean section do have lower blood volumes. However, their treatment of delayed cord clamping has not stood the test of time because the lower blood volume resulting from cesarean section makes little difference in clinical practice. If they had run a trial and presumably found that their delayed cord clamping procedure was ineffective, they might have sorted out that these infants delivered by cesarean section before the onset of labor had respiratory syndromes that we now call respiratory distress syndrome or transient tachypnea of the newborn. Cesarean section delivery of infants to women who are not in labor continues to be an iatrogenic cause of respiratory distress syndrome in near-term infants. Alan H. Jobe, MD, PhD Division of Pulmonary Biology Children’s Hospital Medical Center Cincinnati, OH 45229-3039
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THE JOURNAL OF PEDIATRICS VOLUME 136, NUMBER 4 Greenberg CR, Bishop AJ. A variant congenital dyserythropoietic anemia presenting as a fatal hydrops foetalis. Br J Haematol 1990;76:438-9. 7. Cantu-Rajnoldi A, Zanella A, Conter U, Faccini P, Soligo D, Gornati G, et al. A severe transfusion-dependent congenital dyserythropoietic anaemia presenting as hydrops fetalis. Br J Haematol 1997;96:530-3. 8. Jijina F, Ghosh K, Yavagal D, Pathare AV, Mohanty D. A patient with con-
genital dyserythropoietic anemia type III presenting with stillbirth. Acta Haematol 1998;99:31-3. 9. Gersony WM. Neonatal pulmonary hypertension: pathophysiology, classification and etiology. Clin Perinatol 1984;11:517-24. 10. Fricker HS, Zumofen W, Hofmann E. Severe neonatal anemia associated with fetomaternal transfusion and persistent fetal circulation. Helv Paediatr Acta 1983;38:179-83.
11. Roberts JD, Polaner MD, Lang P, Zapol WM. Inhaled nitric oxide in persistent pulmonary hypertension of the newborn. Lancet 1992;340: 818-9. 12. Tchernia G, Dommergues M, Zupan V, Chambost H, Wickramasighe SN, Bader-Meunier B. Severe congenital dyserythropoietic anemia type I. Antenatal management, transfusion support, and interferon α therapy. [Abstract] Pediatr Res 1999;45:759.
50 Years Ago in The Journal of Pediatrics DEATH OF CESAREAN INFANTS: A THEORY AS TO ITS CAUSE AND A METHOD OF PREVENTION Landau DB, Goodrich HB, Francka WF, Burns FR. J Pediatr 1950;36:421-6 In 1950 Landau and associates reported that infants born by cesarean section often died of asphyxia, an outcome that could be decreased by the spontaneous onset of labor before cesarean section. They further noted that the infants develop “cyanosis, respiratory distress with dyspnea, air hunger, and costal retractions with rapid weak pulse” within hours. They proposed that the major problem was shock resulting from cord clamping immediately after delivery. They reported their favorable experience with a delayed cord clamping procedure, designed to increase the intravascular volume of infants delivered by cesarean section. They then said that they could not justify a controlled trial because their results were so good. In hindsight, their physiology was correct: infants delivered by cesarean section do have lower blood volumes. However, their treatment of delayed cord clamping has not stood the test of time because the lower blood volume resulting from cesarean section makes little difference in clinical practice. If they had run a trial and presumably found that their delayed cord clamping procedure was ineffective, they might have sorted out that these infants delivered by cesarean section before the onset of labor had respiratory syndromes that we now call respiratory distress syndrome or transient tachypnea of the newborn. Cesarean section delivery of infants to women who are not in labor continues to be an iatrogenic cause of respiratory distress syndrome in near-term infants. Alan H. Jobe, MD, PhD Division of Pulmonary Biology Children’s Hospital Medical Center Cincinnati, OH 45229-3039
555