Waiting for adjustments in fetal circulation

    Montgomery (1960) stated:

    “Tying of the umbilical cord was never employed until the ligature
    became common practice in surgery.” [17, p904-5]

    Montgomery (1960, 1962) described with pictures placing the newborn baby
    on a table next to the delivery bed, resuscitation if needed with the cord
    intact, then waiting for the cord to become flaccid and thus easily severed
    [17, 18].  See figure on the following page (in a new browser window) >>.

    Montgomery (1960) described his procedure for cesarean delivery, following
    which he held the baby face down below the level of the uterus, then:

    “Generally within 5 minutes with the baby held in this position,
    the respiratory passages of the fetus are cleared, adjustments
    in fetal circulation occur, blood has come over from the placenta,
    pulsation of the umbilical cord stops, and the cord then can be
    safely severed.” [2, p908]

    The figure on the following page illustrates the appearance of the cord once
    pulsations in it have ceased, then its appearance following ligation showing
    very little bleeding.
    -------
17. Montgomery TL. The umbilical cord. Clin Obstet Gynecol. 1960 Dec;3:900-10.
18. Montgomery TL. Immediate care of the newborn. Clin Obstet Gynecol. 1962
     Mar;5:30-43.
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New Decade
Dr. Morley
Neonatal transition
Dr. Hutchon

Instrument of harm
Apgar
The first breath
>>Postnatal placental circulation



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