SUstained Cord Circulation after Emergency Cesarean Section (SUCCECS) — a new concept for resuscitating neonates

Intrapartum asphyxia is a major cause if infant mortality and morbidity.

Today, compromised infants at risk of asphyxia, born with cesarean section, will have their cord cut immediately and lose the many positive effects of delayed cord clamping, described in systematic reviews.

A new approach, shown in pilot studies to promote transition and recovery, as well as later neurodevelopment, is resuscitation with an intact cord.The purpose of this multi-center randomized controlled trial is to provide evidence regarding resuscitation performed while keeping an intact cord circulation in emergency cesarean section.

The aim is to provide a new, safe intervention for enhanced neonatal recovery and neurodevelopment, while decreasing morbidity and mortality after emergency cesarean section.PopulationNeonates ≥35+0 w, by emergency cesarean section with signs of fetal compromiseInterventionResuscitation performed in the operating theater while keeping an intact cord circulationControlResuscitation according to current practice; cord clamping is performed immediatelyOutcome Assessment of the child´s development at 4, 12, 24 and 48 months of ageThe executive group will, together with the steering committees members from the affiliated hospitals, organize preparatory studies, including audit of current practice, systematic literature review, registry study, feasibility tests and preparatory workshops during 2022 and 2023.

Start of the randomized controlled trial is planned to 2024.