Effects Of Umbilical Cord Milking Research Articles

Cardiac and cerebral hemodynamics with umbilical cord milking compared with early cord clamping: A randomized cluster crossover trial

ObjectiveA large, randomized cluster cross-over trial (N = 1730) comparing intact umbilical cord milking (UCM) to early cord clamping (ECC) in non-vigorous near-term/term newborns demonstrated a reduction in cardiorespiratory interventions at birth and less moderate to severe hypoxic ischemic encephalopathy. We evaluated changes in cerebral tissue oxygenation (StO2), pulse oximetry (SpO2), pulse rate and fraction of inspired oxygen (FiO2) during the first 10 min of life in a subset of infants enrolled in the parent trial. Study designInfants enrolled in the Milking in Non-Vigorous Infants trial that had StO2 monitoring at birth were included in the sub-study conducted at 3 hospitals the US and Canada. A near-infrared spectroscopy sensor, pulse oximeter and electrocardiogram electrodes were placed. Pulse rate, StO2, SpO2, and FiO2 were collected for the first 10 min after birth. Longitudinal models were used to compare effects of UCM and ECC. ResultsThirty-four infants had StO2 data. Fifteen of these infants received UCM and 19 had ECC. Infants receiving UCM had similar heart rates, SpO2, and StO2 values, but were exposed to less FiO2 over the first 10 min of life than infants with ECC (0.26 ± 0.12 vs. 0.81 ± 0.05 at 10 min). ConclusionNon-vigorous term/near term infants who received UCM at birth required lower FiO2 after delivery when compared to infants who umbilical cords were clamped soon after birth while achieving similar peripheral and cerebral oxygenation. Cord milking may be a potential option for placental transfusion in non-vigorous near term/term infants when delayed cord clamping cannot be performed.

The haemodynamic effects of umbilical cord milking in term infants: a randomised controlled trial.

Umbilical cord milking (UCM) is a method that allows for postnatal placental transfusion. The benefits of UCM have been demonstrated in some studies, but knowledge about its haemodynamic effects in term infants is limited. The aim of this study was to evaluate the haemodynamic effects of UCM in term infants. In this prospective, randomised controlled study, 149 healthy term infants with a birth week of ≥37 weeks were randomly assigned to either the UCM or immediate cord clamping (ICC) group. Blinded echocardiographic evaluations were performed in all the neonates in the first 2-6 h. Superior vena cava (SVC) flow measurements were higher in the UCM group compared to the ICC group (132.47 ± 37.0 vs. 126.62 ± 34.3 mL/kg/min), but this difference was not statistically significant. Left atrial diameter (12.23 ± 1.99 vs. 11.43 ± 1.78 mm) and left atrium-to-aorta diastolic diameter ratio (1.62 ± 0.24 vs. 1.51 ± 0.22) were significantly higher in the UCM group. There were no significant differences in other echocardiographic parameters between the two groups. We found no significant difference in the SVC flow measurements in term infants who underwent UCM versus those who underwent ICC. This lack of significant difference in SVC flow may be explained by the mature cerebral autoregulation mechanism in term neonates.

Delayed Cord Clamping Versus Cord Milking In Preterm Neonates

Abstract Background Current guidelines suggest delayed cord clamping (DCC)as it reduces mortality and allows more placental transfusion. Another technique, umbilical cord milking (UCM), provides a placental transfusion without delaying resuscitation and can be completed as quickly as immediate cord clamping Objective To Investigate clinical and laboratory effects of UCM compared to DCC in preterm neonates. Subjects & Methods Preterm neonates <37 weeks were randomized into two groups DCC for 6o seconds and UCM (stripping 20 cm of umbilical cord 4 times at a speed of 10 cm /second towards the baby then cord was clamped. After stabilization of neonates, blood samples were taken after two hours for all neonates for assessment of hemoglobin, hematocrit and bilirubin. Results Most of the neonates included in our study were born through lower segment caesarean section (LSCS) 73(73%) in DCC group and 86(86%) in UCM group. On the other hand, 27(27%) of neonates in DCC group and 14 (14%) in milking group were delivered by vaginal delivery (VD). There was statistical significance increase of LSCS than VD. (p = 0.023) Instrument used during delivery was forceps 3% for DCC and 2% for UCM group and ventose was not used on any of our neonates. Tactile stimulation and warming were performed for all our neonates. Some neonates required interventions for resuscitation like oxygen supplementation (31 % DCC and 36% UCM), positive pressure ventilation (23%DCC, 28 %UCM), fluid bolus (none in DCC group and 2% in UCM group) or intubation (7% DCC, 9% UCM) noting that no cases required any drug e.g. adrenaline intervention. Positive pressure ventilation without intubation included ambu bag or neopuff was used in 23% and 28 % in DCC group and UCM group respectively. No statistical difference was found in the abovementioned data. Apgar score was recorded for every neonate at 1 and 5 minutes of resuscitation to assess transition and any need for further resuscitation measures. Apgar at 1minute median 6 in DCC and CM group(p = 0.346). Apgar at 5minutes median 8.5 in DCC group and 9 in CM group(p = 0.646). No statistical difference was found in Apgar scores between two groups. Laboratory data including serum hemoglobin, hematocrit and bilirubin level were recorded from a blood sample taken within 2 hours of delivery. The mean hemoglobin, hematocrit in the DCC group was 17.06 (2.35) mg/dl, 48.32 (6.86) mg/dl respectively. The UCM group hemoglobin and hematocrit mean was 17.16 (2.34) mg/dl and 49.11(6.55) mg/dl respectively. Mean for serum bilirubin in DCC group was 3.15(3.02) g/dl and for UCM group was 2.91(2.43) mg/dl. No statistical difference was found between DCC and UCM in the laboratory data. Conclusion UCM and DCC resulted in comparable clinical and laboratory results including resuscitating maneuvers used, hemoglobin, hematocrit bilirubin at 2 hours of life implying that similar amount of placental transfusion occurs in both the groups with no increased risk in UCM group. UCM can be performed in any low resource setting and provides adequate placental transfusion to the premature newborn without delay of resuscitation, making it feasible for depressed neonates as well.

Effect of Umbilical Cord Milking on Maternal and Neonatal Outcomes in a Tertiary Care Hospital in South India: A Randomized Control Trial.

Umbilical cord milking (UCM) has been theorized to increase placental blood transfusion then again, the optimal method of cord clamping at birth is still contested. We aimed to analyse the effects of UCM on the neonatal haematological parameters at 72h and 6weeks of age and its association with any adverse effects. In this randomized control trial, mothers ≥ 34weeks were randomized into two arms. Under the intervention group, the cord was milked three times before clamping and cutting whereas the controls had the cord clamped and cut without milking. Haemoglobin and haematocrit levels were measured at 72h. and at 6weeks. A total of 170 mothers were enrolled with 85 subjects in each arm. Baseline characteristics were comparable. In the intervention arm, the mean haemoglobin [18.1 (2.4) g/dL] and haematocrit [54 (7) %] were significantly higher as compared to the control arm [16.4 (2.1) g/dL and 48 (6) %], at 72h of age. There was also significant increase in the mean haemoglobin [11.6 (1.3) g/dL] and haematocrit [34 (4) %] compared to the controls [10.1 (1.1) g/dL and 30 (3) %], at 6weeks. No statistical difference was found in the incidence of PPH and duration of third stage. There was no significant rise in hyperbilirubinaemia, phototherapy requirement and polycythaemia among neonates in the intervention group. Umbilical cord milking is a sound practical approach to raise the haemoglobin and haematocrit levels up to 6weeks thereby decreasing the proportion of anaemic infants.

Effect of Cord Milking in Late Preterm Infants and Full-term Infants: A Systematic Review and Meta-analysis

(Birth. 2020;47:259–269) Delayed cord clamping (DCC) is associated with many benefits for neonates including higher neonatal hemoglobin and additional iron stores, but it is not always feasible. Umbilical cord milking (UCM) can be an alternative. The use of UCM has been found to be beneficial in premature infants in one meta-analysis, but there was not enough data to suggest benefits to full-term infants. Another review found most studies showed full-term and late-preterm infants benefited from UCM or DCC compared to immediate cord clamping. This study aimed to evaluate the effects of UCM for full-term and late-preterm infants and stratify the results by gestational age and method.

Umbilical cord milking versus delayed cord clamping in term infants: a systematic review and meta-analysis.

Delayed cord clamping (DCC) is recommended for healthy term infants. However, the effectiveness of umbilical cord milking (UCM) in term infants remains unknown. The study aimed to compare the effects of UCM versus DCC on term infants. A systematic review and meta-analysis were conducted which included individual and clustered RCTs comparing UCM with DCC for infants born at ≥37 weeks of gestation. Three trials (650 term infants) were included. Compared with DCC, UCM was associated with higher hemoglobin levels at 6 weeks after birth [infants, 621; mean difference, 0.17; 95% confidence interval, 0.05-0.29] and had no statistical differences in hemoglobin levels at birth, serum bilirubin levels at 48 h after birth, or hematocrit levels at 48 h after birth. This study suggested that UCM might be as beneficial as DCC in term infants, however, further RCTs are required to accurately assess the outcomes.

Effects of cord milking in late preterm infants and full-term infants: A systematic review and meta-analysis.

Umbilical cord milking (UCM) consists of performing several milkings of the cord from the placenta to the newborn. The objective was to evaluate the effects of UCM on newborns ≥34weeks' gestation. Searches were conducted in MEDLINE, EMBASE, CINAHL, the Cochrane Database of Clinical Trials, and the clinicaltrails.gov database for randomized clinical trials (RCT), with no time or language restrictions, and for articles that compared UCM with other strategies. The main results were initial hemoglobin and hemoglobin after 6weeks. The data were collected by two reviewers and the quality of the studies was assessed using the Cochrane Manual methodology. The sample included 1845 newborns in 10 RCTs. The use of UCM in ≥34weeks' gestation newborns was not related to initial hemoglobin levels (pooled weighted mean difference: (PWMD=0.40g/L [-0.16 to 0.95]) or after 6weeks (PWMD=0.07g/L [-0.29 to 0.27]). A reduction in hemoglobin levels was also observed at 6weeks when the control group had undergone late clamping (PWDM=0.16g/L [-0.26 to -0.06]). UCM produced no differences in hematologic variables for newborns with ≥34weeks of gestation relative to controls. However, a slight decrease in hemoglobin levels is observed at 6weeks when the control group is made up of newborns with late clamping.

Effects of Umbilical Cord Milking on Anemia in Preterm Infants: A Multicenter Randomized Controlled Trial.

This study aimed to investigate whether umbilical cord milking (UCM) prevents and controls anemia in preterm infants, as compared with immediate cord clamping (ICC). Pregnant women delivering at <34 weeks' gestation in four hospitals were randomly assigned to undergo UCM or ICC from July 2017 to June 2019. Hematological parameters and iron status were collected and analyzed as primary outcomes at 24 hours, 1 week, 2 weeks, and 6 months after delivery. Neonates receiving UCM had significant higher levels of hemoglobin (Hb), hematocrit, and serum iron (p < 0.05). Lower prevalence of anemia and lower need for transfusions were noted in UCM group. Although UCM was associated with prolonged duration of phototherapy, the maximum levels of bilirubin were similar between two groups (p > 0.05). UCM is an effective intervention to help preterm infants experience less anemia with the potential to increase blood volume, as seen by higher Hb levels and more enhanced iron stores.

Early Cardiac and Cerebral Hemodynamics with Umbilical Cord Milking Compared with Delayed Cord Clamping in Infants Born Preterm

To evaluate changes in cerebral oxygenation, peripheral arterial oxygenation, respiratory status, and administered fraction of inspired oxygen during the first 10minutes of life in premature infants receiving umbilical cord milking compared with delayed cord clamping (DCC). Premature infants born at 230/7 to 276/7weeks of gestation were randomized to umbilical cord milking or DCC. A near infrared spectroscopy sensor, pulse oximeter, and electrocardiogram electrodes were placed. Pulse rate, cerebral tissue oxygenation, peripheral oxygen saturation, airway pressure, and fraction of inspired oxygen were collected for 10minutes in the delivery room. Longitudinal models were used to compare effects of umbilical cord milking and DCC. Fifty-six infants had cerebral oximetry and advanced monitoring at birth. There was an increased incidence of severe intraventricular hemorrhage in infants who received umbilical cord milking compared with DCC (P=.0211). Longitudinal models suggested that peripheral oxygen saturation was higher in the umbilical cord milking group in the first 4minutes (P=.0221) and that mean airway pressures were lower in the umbilical cord milking group after the first 7minutes (P=.0072). No statistical differences were observed for fraction of inspired oxygen, cerebral tissue oxygenation, or heart rates. The data suggest that the rapid transfer of blood during umbilical cord milking may facilitate lung expansion with improved pulmonary blood flow, but may also increase cerebral blood flow, resulting in severe intraventricular hemorrhage. ClinicalTrials.gov: NCT03145142.

Umbilical Cord Milking in Infants Born at

Umbilical cord milking (UCM) could be an alternative in cases where delayed umbilical cord clamping cannot be performed, therefore our objective was to evaluate the effects of UCM in newborns <37 weeks’ gestation. In this systematic review and meta-analysis, we searched MEDLINE, EMBASE, CINAHL, the Cochrane Database of Clinical Trials, the clinicaltrails.gov database for randomized UCM clinical trials with no language restrictions, which we then compared with other strategies. The sample included 2083 preterm infants. The results of our meta-analysis suggest that UCM in premature infants can reduce the risk of transfusion (relative risk (RR)= 0.78 [95% confidence interval (CI),0.67–0.90]) and increase hemoglobin(pooled weighted mean difference (PWMD)= 0.89 g/L[95%CI 0.55–1.22]) and mean blood pressure (PWMD=1.92 mmHg [95% CI 0.55–3.25]). Conversely, UCM seems to increase the risk of respiratory distress syndrome (RR = 1.54 [95% CI 1.03–2.29]), compared to the control groups. In infants born at <33 weeks, UCM was associated with a reduced risk of transfusion (RR= 0.81 [95%CI 0.66–0.99]), as well as higher quantities of hemoglobin (PWMD= 0.91 g/L[95%CI 0.50–1.32]). UCM reduces the risk of transfusion in preterm infants, and increases initial hemoglobin, hematocrit, and mean blood pressure levels with respect to controls.

Effects of Umbilical Cord Milking on Term Infants Delivered by Cesarean Section.

Umbilical cord milking (UCM) is an efficient way to achieve optimal placental transfusion in term infants born by cesarean section (CS). However, it is not frequently performed due to concern for short-term adverse effects of increased blood volume, such as polycythemia and hyperbilirubinemia. The aim of this study is to evaluate the short-term effects of UCM on term infants delivered by CS. We conducted a pre- and postimplementation cohort study comparing term infants delivered by CS who received UCM five times (141 infants, UCM group) during a 6-month period (August 1, 2017 to January 31, 2018) to those who received immediate cord clamping (ICC) during the same time period (105 infants, postimplementation ICC) and during a 3-month period (October1, 2016 to December 31, 2016) prior to the implementation of UCM (141 infants, preimplementation ICC). Mothers were older in UCM group compared with both ICC groups. There were no significant differences in other maternal or neonatal characteristics. Although this study was not powered to detect differences in outcomes, the occurrence of hyperbilirubinemia needing phototherapy, symptomatic polycythemia, NICU admissions, or readmissions for phototherapy was similar between the groups. UCM intervention was not associated with increased incidence of phototherapy or symptomatic polycythemia in term infants delivered by CS.

Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes.

Background Optimal timing for clamping the umbilical cord at preterm birth is unclear. Early clamping allows for immediate transfer of the infant to the neonatologist. Delaying clamping allows blood flow between the placenta, the umbilical cord and the baby to continue. The blood which transfers to the baby between birth and cord clamping is called placental transfusion. Placental transfusion may improve circulating volume at birth, which may in turn improve outcome for preterm infants. Objectives To assess the short- and long-term effects of early rather than delaying clamping or milking of the umbilical cord for infants born at less than 37 completed weeks' gestation, and their mothers. Search methods We searched the Cochrane Pregnancy and Childbirth Group Trials Register (31 May 2011). We updated this search on 26 June 2012 and added the results to the awaiting classification section. Selection criteria Randomised controlled trials comparing early with delayed clamping of the umbilical cord and other strategies to influence placental transfusion for births before 37 completed weeks' gestation. Data collection and analysis Three review authors assessed eligibility and trial quality. Main results Fifteen studies (738 infants) were eligible for inclusion. Participants were between 24 and 36 weeks' gestation at birth. The maximum delay in cord clamping was 180 seconds. Delaying cord clamping was associated with fewer infants requiring transfusions for anaemia (seven trials, 392 infants; risk ratio (RR) 0.61, 95% confidence interval (CI) 0.46 to 0.81), less intraventricular haemorrhage (ultrasound diagnosis all grades) 10 trials, 539 infants (RR 0.59, 95% CI 0.41 to 0.85) and lower risk for necrotising enterocolitis (five trials, 241 infants, RR 0.62, 95% CI 0.43 to 0.90) compared with immediate clamping. However, the peak bilirubin concentration was higher for infants allocated to delayed cord clamping compared with immediate clamping (seven trials, 320 infants, mean difference 15.01 mmol/L, 95% CI 5.62 to 24.40). For most other outcomes (including the primary outcomes infant death, severe (grade three to four) intraventricular haemorrhage and periventricular leukomalacia) there were no clear differences identified between groups; but for many there was incomplete reporting and wide CIs. Outcome after discharge from hospital was reported for one small study; there were no significant differences between the groups in mean Bayley II scores at age seven months (corrected for gestation at birth (58 children)). No studies reported outcomes for the women. Authors' conclusions Providing additional placental blood to the preterm baby by either delaying cord clamping for 30 to 120 seconds, rather than early clamping, seems to be associated with less need for transfusion, better circulatory stability, less intraventricular haemorrhage (all grades) and lower risk for necrotising enterocolitis. However, there were insufficient data for reliable conclusions about the comparative effects on any of the primary outcomes for this review.

Effects of umbilical cord milking on premature neonates’ and mothers’ outcomes

Background: Umbilical Cord Milking (UCM) is a safe and likely technique for both the mothers and their neonates which improve the neonatal outcomes. The aim of the study was to assess the effects of umbilical cord milking on premature neonates' and mothers' outcomes.Methods: Design: Quasi-experimental research design was utilized. Setting: Emergency and Labor Unit of Women's Health University Hospital and Neonatal Intensive Care Unit (NICU) in Assiut University Children Hospital were the setting which the study was implemented. Subjects: It included 80 mothers and their premature neonates. The subjects were divided randomly into two groups (40 premature neonates who were received the UCM as a study group and 40 premature neonates as a control group who received the Immediate Cord Clamping [ICC]). Tool: One structured interview questionnaire was designed especially for this study. It included two parts: Personal and clinical data of the studied mothers and premature neonates.Results: The Hemoglobin (Hb) level significantly increased in the study group when compared to the control group within 6 hours of birth (12.11 vs. 10.61) and at 36-48 hours after UCM (12.27 vs. 11.32). Also, UCM had significantly improved the need for blood transfusion, death rate, and length of hospital stay among premature neonates in the study group.Conclusions and recommendations: UCM improved preterm neonates' outcomes as increasing Hb level, less need for blood transfusion, and decline incidence of death, lowers length of hospital stay. Recommendations: Increasing awareness of neonatology, pediatric, and obstetric nurses about benefits and technique of UCM through health education program.

Delayed clamping vs milking of umbilical cord in preterm infants: a randomized controlled trial

It has been established that delayed umbilical cord clamping in preterm infants results in improvement in neonatal anemia, need for transfusion, incidence of necrotizing enterocolitis, and intraventricular hemorrhage by increasing neonatal circulating blood volume. However, the effects of umbilical cord milking as an alternative to delayed clamping in preterm infants are unclear. The primary objective of this study was to compare the effect of delayed clamping vs milking of the umbilical cord on the initial hematocrit concentration in preterm births (23-34 weeks gestation). In addition, we sought to compare the effects of delayed clamping vs milking on the incidences of intraventricular hemorrhage, necrotizing enterocolitis, and need for transfusion (secondary objectives). The study was an unblinded randomized controlled trial of singleton preterm infants who were born 23 weeks 0 days to 34 weeks 6 days gestation and were assigned to 1 of 2 controlled study groups: delayed cord clamping for 60 seconds or milking of the cord towards the infant 4 times before clamping. Randomization occurred via block randomization with an allocation ratio of 1 to 1. The patients' third stage of delivery was standardized for route of delivery and randomization arm. All comparisons were preformed with an intent-to-treat analysis approach. The study was powered at 80% with a probability value of .05 for the primary outcome measure of a hematocrit difference of 3% between the 2 groups. Of the 204 randomized patients, 104 were assigned to the delayed subgroup, and 100 were assigned to the milking subgroup. There were no significant differences in baseline maternal characteristics noted between groups. Though there was not any statistically significant difference in neonatal outcomes between the cord clamping and milking groups, the occurrences of transfusion (15.5% vs 9.1%; P=.24), necrotizing enterocolitis (5.8% vs 3.0%; P=.49), and intraventricular hemorrhage (15.5% vs 10.1%; P=.35) were all lower in the milking group. The milking group had higher initial hematocrit concentration compared with the delayed clamping group, although this was not significant (51.8 [6.2%] vs 49.9 [7.7%]; P=.07]. Peak bilirubin levels and need for phototherapy were similar between groups. This study demonstrates that milking the umbilical cord may be an acceptable alternative to delayed cord clamping because there were similar effects on neonatal hematocrit concentrations and the need for neonatal transfusions and no increased risk for complications or neonatal morbidity. The present data support the concept that milking of the umbilical cord may offer an efficient and timely method of providing increased blood volume to the infant.

Milking of the Umbilical Cord in Term and Late Preterm Infants.

Introduction Umbilical cord milking is a procedure in which clamped or unclamped umbilical cord is grasped, and blood is pushed (“stripped”) two to four times towards the newborn, in a rapid time frame, usually within 20 seconds. The target of umbilical cord milking is to provide infants with their whole potential blood volume—of which they are deprived when early cord clamping is carried out—completing placental transfusion in a shorter time than delayed cord clamping. The aim of this narrative review is to analyse the literature regarding umbilical cord milking in term and late-preterm infants and to assess all possible benefits and limits of this procedure in clinical practice, especially in comparison to immediate and delayed cord clamping. Methods We analysed literature data concerning maternal, as well as neonatal, outcomes for term and late-preterm (gestational age ≥ 34 weeks) newborns who received umbilical cord milking. Results Most studies show comparable benefits for both umbilical cord milking and delayed cord clamping, especially in terms of haematological parameters when compared to immediate cord clamping. Umbilical cord milking may be a feasible procedure also for newborns requiring resuscitation. Conclusions Literature data concerning positive effects of umbilical cord milking are encouraging and suggest that umbilical cord milking may be a quick and effective method to provide placental transfusions to depressed infants. However, the lack of standardised procedures and the variation in evaluated outcomes as well as the limited number of patients enrolled in trials, along with the retrospective nature of some of them, prevent recommending umbilical cord milking as a routine procedure.

Early effects of umbilical cord milking on hemoglobin, bilirubin and cardiac function in premature infants

Early effects of umbilical cord milking on hemoglobin, bilirubin and cardiac function in premature infants

Effects of umbilical cord milking compared to differed cord clamping in term infants, a randomized controlled trial

Introduction: Differed cord clamping (DCC) at delivery is currently recommended to increase neonatal haemoglobin levels (Hb) and reduce the risk of infant anemia. It needs waiting for two to three minutes, which is considered to be associated with most of its unwanted effects. An alternative could be umbilical cord milking (UCM) with early clamping. Although effects of UCM have been assessed in preterm neonates such evidence is sparse for term neonates. Objectives: To evaluate whether the effects on Hb, bilirubin and haemodynamic parameters in infants, and blood loss in the mother are better with UCM than with DCC during elective caesarean delivery at term. Methods: Sixty term pregnant mothers undergoing elective caesarean delivery (CD) in Teaching Hospital Kandy, from 1st February to 31st March 2015 were randomized to UCM and DCC. The UCM group had the umbilical cord milked towards the umbilicus of the baby in a standard method soon after delivery. The DCC group had the umbilical cord clamped after two minutes of delivery or once the cord pulsations had ceased. Neonatal Hb, bilirubin and haemodynamic parameters, and maternal blood loss were assessed within 48 hours of delivery. Results: Thirty three participants underwent UCM while 27 participants underwent DCC. Main indications for the CD were past CD (47%), failed induction (12%), past bad obstetric history (10%), maternal medical conditions (8%) and suspected gross cephalo pelvic disproportion (8%). All CD were performed under spinal aneasthesia. There were no significant differences between the UCM and DCC groups with regard to mean neonatal Hb (17.6g/dl, sd 2.0 vs 17.4g/dl, sd 2.4, p=0.67), mean neonatal total bilirubin (111.8 mmol/l, sd 47.6 vs 123.0mmol/l, sd 35.0, p=0.69) and mean maternal decrease in Hb (1.0g/dl, sd 0.7 vs 1.3g/dl, sd 1.0, p=0.37). All the neonates had birth APGAR of 10 at 5 minutes. The volume of blood remaining in the placenta was significantly higher in the UCM group (29.5ml, sd 20.3 vs 19.5ml, sd 13.1, p=0.03). Conclusions: Neonatal and maternal outcomes are not better with UCM than with DCC during elective CD.

Haemodynamic effects of umbilical cord milking in premature sheep during the neonatal transition

ObjectiveUmbilical cord milking (UCM) at birth may benefit preterm infants, but the physiological effects of UCM are unknown. We compared the physiological effects of two UCM strategies with immediate umbilical...

Effects of Umbilical Cord Milking on the Need for Packed Red Blood Cell Transfusions and Early Neonatal Hemodynamic Adaptation in Preterm Infants Born ≤1500 g

The aim of this study was to evaluate the effects of umbilical cord milking (UCM) on the need for packed red blood cell (PRBC) transfusion and hematologic and hemodynamic parameters in very-low-birth-weight infants. The infants were randomized into 2 groups: group 1 (UCM) and group 2 (control). The primary outcome was the number of PRBC transfusions during the first 35 days of life. The secondary outcome measures were the hemodynamic variables during the first 24 hours of life. A total of 44 infants were included with 22 infants in each group. Two of 21 infants in group 1 and 4 of 21 infants in group 2 received transfusion in the first 3 days of life (P=0.384). The number and volume of PRBC transfusions were similar in both groups. However, the levels of hemoglobin (Hb) at the first and 24th hour of life were significantly higher in group 1. Phlebotomy volume was found as a statistically significant risk factor for the need for PRBC transfusion (P=0.005). UCM in delivery room results in a higher Hb level in the first day of life. In these groups of infants, phlebotomy losses may impact the transfusion need.

PO-0611 Effects Of Umbilical Cord Milking On The Need For Packed Red Blood Cell Transfusions And Early Neonatal Haemodynamic Adaptation In Preterm Infants Born =1500 G

Objective The aim of this study was to evaluate the effects of umbilical cord milking (UCM) on the need for packed red blood cell (PRBC) transfusion and hematologic and haemodynamic parameters in very-low–birth-weight infants. Methods The infants were randomised into 2 groups: group 1 (UCM) and group 2 (control). The primary outcome was the number of PRBC transfusions during the first 35 days of life. The secondary outcome measures were the haemodynamic variables during the first 24 h of life. Results A total of 44 infants were included with 22 infants in each group. Two of 21 infants in group 1 and 4 of 21 infants in group 2 received transfusion in the first 3 days of life (p = 0.384). The number and volume of PRBC transfusions were similar in both groups (Table 1). Comparison of laboratory outcomes resulted in statistically significance only in median Hb values at first (16.8 g/dL [range, 14.1 to 18.8 g/dL] and 15.4 g/dL [range, 12.3 to 18.5 g/dL]; p = 0.019) and 24th hour after birth (16.1 g/dL [range, 13.4 to 21 g/dL] and 14.9 g/dL [range,10.2 to 18 g/dL]; p = 0.021) between UCM and control groups, respectively. Phlebotomy volume was found as a statistically significant risk factor for the need for PRBC transfusion (p = 0.005). Conclusions UCM in delivery room results in a higher Hb level in the first day of life. In these groups of infants, phlebotomy losses may impact the transfusion need.