Umbilical Cord Milking versus Delayed Cord Clamping and Associations with In-Hospital Outcomes among Extremely Premature Infants

Background: Early cord clamping and cutting of the umbilical cord is widely practiced as part of the management of labor; it could deprive the neonate of about a quarter of its blood volume and iron. This thesis is aimed at comparing effects of delayed cord clamping versus umbilical cord milking at birth in preterm and early term infants.Methods: This single centered randomized study was conducted in Department of Pediatrics and data collection was done on the basis of the preterm and early term infants delivered by vaginal or cesarean delivery in Department of Gynecology, Geetanjali Medical College and Hospital, Udaipur during period of January 2016 to January 2017. Total of 120 infants were included in the study.Results: Statistically it has been analyzed that in both pre-term and early term infants who underwent DDC and UCM, there was insignificant difference in level of hemoglobin (Hb), haematocrit (HCT), blood sugar, bilirubin level (TSB) and temperature of body. On the other hand, significant difference was observed in weight and cord pH of neonates of both groups. There is also insignificant difference in terms of NICU admission for RDS, sepsis, phototherapy, need of oxygen, saline boluses, PRBC transfusion, polycythemia.Conclusions: Thus, overall it was observed that there is insignificant difference in delayed cord clamping and umbilical cord milking group. Thus, both are found to be equally effective in improving hematologic parameters.

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A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20201540 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1017

Author(s):

Sahana Devadas ◽

Roshni R. ◽

Mallesh K.

Keyword(s):

Umbilical Cord ◽

Iron Status ◽

Ferritin Level ◽

Clinical History ◽

Randomised Control Trial ◽

Preterm Neonates ◽

Delayed Cord Clamping ◽

Iron Stores ◽

Cord Clamping ◽

Umbilical Cord Milking

Background: Perinatal iron deficiency has received little attention in the past. Umbilical cord milking is a type of placental transfusion, they serve to potentially enhance neonatal blood volume and consequently the iron stores after birth. Among the neonates, the preterm infants are sick and vulnerable babies who are already deprived of iron stores. The aim of this study was to evaluate the effect of cord milking on ferritin values amongst preterm neonates.Methods: This is a hospital based randomized control trial which included the babies born at 29-36 weeks of gestation. The babies were randomized to two intervention groups; cord milking and delayed cord clamping group. Detailed clinical history taken, including details of labour and clinical examination. Blood samples were analysed for ferritin as required at 6 weeks of post-natal age.Results: Neonates under cord milking group had higher ferritin values (249.04±21.93 ng/mL) as compared to those neonates under delayed cord clamping group (179.66±32.94 ng/mL) and this was statistically very significant (p= <0.001).Conclusions: In preterm neonates, umbilical cord milking results in improved iron status as shown by higher ferritin values at 6 weeks of life. UCM can be a used as placental transfusion strategy in preterm neonates for improving iron status and preventing anemia of prematurity.

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