Prone Positioning During Delayed Cord Clamping

Inclusion Criteria:

• Pregnant patient admitted for diagnosis that could result in a preterm delivery

• Anticipated gestational age of delivery could be between 25w+0d - 29w+6d

• Fetus without major anomalies or known genetic condition that could impactrespiratory status or need for intubation at birth

• Singleton or twin gestation

• Neonate eligible for delayed cord clamping based on institutional protocol

• Patient is able to understand study procedures and is willing and able to consent

Exclusion Criteria:

• Triplet or higher order gestation

• Maternal or fetal/neonatal contraindication to delayed cord clamping

• Major fetal anomaly that would be expected to impact delivery room intubation ratessuch as:

• Major congenital cardiac defect (not isolated atrial septal defect/ventricularseptal defect)

• Significant fetal arrhythmia at the time of delivery

• Fetal tumor

• Renal anhydramnios (not isolated urinary tract dilation with normal fluid)

• Congenital Diaphragmatic Hernia

• Heterotaxy

• Moderate to severe ventriculomegaly or other major brain malformation (not mildisolated ventriculomegaly)

• Airway obstruction

• Underlying genetic disease that could impact respiratory function at delivery

• Arthrogryposis (not apparently isolated clubbed foot)

• Skeletal dysplasia

• Pregnant patient is unable to understand study materials or is unwilling or unableto consent

• Acute maternal obstetric emergency that precludes time or maternal focus for theconsent process to take place