Pédiatre - HUDERF
2022-2023, 2023-2024: "Bourse en mémoire de Professeur Samy Cadranel"
Strategies To Improve Transition To Extra-Uterine Life
Queen Fabiola Children’s University Hospital (Neonatal Intensive Care Unit) and Brugmann University Hospital (Department of Gynecology and Obstetrics).
The purpose of this work is to improve the transition to extrauterine life in infants born at various gestational ages and using different strategies. To achieve this goal, we will
- firstly implement well known evidence-based strategies (e.g., neonatal resuscitation guidelines, golden hour protocol, thermal protection, and delayed cord clamping).
- Secondly, we will use new strategies, such as PBCC and respiratory function monitor, and evaluate their effect on the quality of neonatal transition and later outcomes.
We hypothesize that combining well-known and innovative strategies would improve neonatal transition in infants and decrease short and long-term comorbidities.
The successful transition from fetal to neonatal life is a major physiological challenge. Especially, establishment of breathing and pulmonary vascular adaptation are the most crucial steps for neonatal transition. At birth, nearly 10% of newborns require some clinical intervention, and less than 1% require more extensive resuscitation. Both known and proven strategies as well as innovative strategies exist to ease difficult transitions. The aim of this research will be to improve adaptation to extrauterine life through better understanding and implementation of these strategies. The first part of this project will be to test the implementation of well-known strategies to enhance birth adaptation. Firstly, we will study the thermal balance of very preterm newborns. Secondly, we will focus on the use of a “golden hour” protocol to be implemented in full-term and preterm newborns. The second part of the project will focus on new strategies to support the newborn. Physiologically-based cord clamping will be assessed in moderate and late preterm infants as well as in full-term infants born after scheduled caesarean section. We will also test the use of a respiratory monitoring function during neonatal resuscitation. Finally, the third part of this project will be dedicated to the implementation of in-situ education program combining these strategies.