Umbilical Cord Milking in Term Infants: Blood Volume Associated With Cut and Intact Umbilical Cords [23M

Abstract

INTRODUCTION: Placental-to-newborn transfusion through delayed cord clamping and umbilical cord milking (UCM) is associated with reduced risk of transfusion, intraventricular hemorrhage, and necrotizing enterocolitis in preterm infants, and increased iron stores in term infants. Total blood volume (BV) transferred during UCM is not well studied. We sought to determine BV associated with both cut UCM (C-UCM) and intact UCM (I-UCM) methods in term infants. METHODS: Forty-five term infants were enrolled at a single center. To determine BV with C-UCM, umbilical cords from 30 infants (10 per group) were cut at 10, 20, or 30 centimeters, milked 4 times, and BV recorded. To determine BV with I-UCM, intact umbilical cords of 15 infants were milked 3 times and BV recorded. Demographic data and pregnancy data were obtained. Descriptive statistics were performed. RESULTS: In the C-UCM group, BV increased proportional to umbilical cord length, whereas BV/cm of cord decreased with cord length. C-UCM of a 30 cm segment contained a mean BV of 24.8±4.0 mL, or 8.0±1.3 mL/kg of birth weight. Most of the BV was obtained with the first milking (90.1±11.0%). In the I-UCM group, the mean BV was 46.3±24.1 mL, or 13.4±7.1 mL/kg of birth weight. No correlation existed between birth weight, placental weight, or BV. CONCLUSION: When performing C-UCM, cutting a long cord segment and milking 1 to 2 times delivers the highest BV. Compared to C-UCM, I-UCM provided greater average BV to newborn term infants. Future research should compare the clinical outcomes of infants who undergo C-UCM and I-UCM.