Placental transfusion and red blood count,
Frischkorn and Rucker (1939)
Frischkorn and Rucker (1939) measured red blood
cell counts in addition to weight in 400 infants. The
cord was not tied until pulsations ceased in 59 cases,
Frischkorn and Rucker described use of sodium
amytal scopolamine analgesia analgesia and ether
anesthesia in all cases. They noted with interest that
the cord continued to pulsate longer than in Budin's
cases, which pre-dated use of anesthesia. In one of
Frischkorn and Rucker's cases, pulsations continued
for 50 minutes.
Blood counts were make within 24 to 36 hours of
birth, with a range of 3.28 to 7.12 million red blood
cells. The average red cell count in the 59 infants
whose cords were not tied until after pulsations
ceased was 5,783,400, as opposed to the average
for 333 cases in which the cord was still pulsating
when tied was 5,198,919; the difference was 584,481.
With the now nearly universal practice of immediate
cord clamping, how many doctors trained in the last
two decades have ever been in attendance at what
Apgar would (within the next 20 years) refer to as a
"slow birth," waiting for pulsations of the cord to
cease. We therefore need to go back to historical
accounts, as in the case of vanishing diseases like
smallpox, neurosyphilis, tuberculosis, leprosy, or
polio. A paper by Frischkorn and Rucker (1939)
paper would be as useful to include in a Cochrane
Review as any of the randomized-controlled trials of
"delayed cord clamping" so highly valued today.
Frischkorn and Rucker provide a description of
postnatal umbilical cord function, that perhaps even in
the 1930s was not waited for or witnessed by many
obstetricians:
"If a cord be watched immediately after delivery the
umbilical vessels can be seen to pulsate strongly
throughout their entire length. In a varying length of
time the pulsations cease in the more distal part and
as this occurs the umbilical vessels collapse. This
process of cessation of pulsation and collapse of the
vessels proceeds toward the umbilicus until finally
there is no pulsation even at the navel. The vessels
are then entirely collapsed. If now the cord be tied
and cut very little blood will escape from the placental
end." [1, p 593]
- Frischkorn HB , Rucker
MP (1939) The
relationship of the time of
ligation of the cord to the
red blood count of the
infant.
- Frischkorn HB , Rucker MP. The relationship of the time of ligation of the
cord to the red blood count of the infant. Am J Ostet Gynecol 1939; 38:
592-594.