American Journal of Obstetrics and Gynecology
ResearchObstetricsEffect of umbilical cord milking in term and near term infants: randomized control trial
Section snippets
Materials and Methods
This study was designed as a single-center, randomized, controlled trial, conducted from April 2010 to September 2011 in the Departments of Pediatrics and Obstetrics at a teaching hospital in North India. Two investigators (A.U. and S.G.) approached expectant mothers and their spouses (parents), explained the study, and obtained the written consent before the birth of the baby.
We included all infants of more than 34 weeks 6 days of completed gestation, delivered either by low uterine segment
Patient characteristics
A total of 700 babies were delivered during the period. Five hundred babies were excluded for different reasons (Figure 1). Two hundred neonates fulfilled the inclusion criteria and were randomized to intervention and control group (100 in each group).
Trial compliance
The mean ferritin and mean Hgb at 6 weeks was higher in the intervention
Comment
Our study demonstrated that the milking of extra blood from about 25 cm of umbilical cord, 3 times into the baby, leads to higher Hgb and serum ferritin after 6 weeks of birth. We also demonstrated relatively higher blood pressure (although within normal range) over an initial period of 48 hours in milked group. Although this might not have been clinically significant in term healthy infants, a gain of 4 mm Hg may be important in hypotensive babies because of hypovolemia. When we analyzed the
Conclusions
Umbilical cord milking is a safe procedure and it improves Hgb and iron status at 6 weeks in term and near term infants, without causing significant increase in respiratory distress, polycythemia, and jaundice.
Acknowledgment
A special thanks to Mr Upendra Kumar Sharma, laboratory technician (LLRM Medical College, Meerut) for his cooperation with the hematological tests.
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Delayed cord clamping vs cord milking in elective cesarean delivery at term: a randomized controlled trial
2024, American Journal of Obstetrics and Gynecology MFMUmbilical cord milking in nonvigorous infants: a cluster-randomized crossover trial
2023, American Journal of Obstetrics and GynecologyCitation Excerpt :UCM has been shown to improve heart rate, blood pressure, urine output, cerebral oxygenation, hemoglobin levels, and prevent anemia in term or near-term infants.14–16 No harm from UCM has been noted in any study among term/near-term infants.12,14–23 Unlike DCC, UCM can achieve significant placental transfusion without significantly delaying resuscitation and be completed almost as quickly as ECC.24
Prevention of postpartum hemorrhage in vaginal deliveries
2023, European Journal of Obstetrics and Gynecology and Reproductive BiologyA 20-cm cut umbilical cord milking may not benefit the preterm infants < 30 week's gestation: A randomized clinical trial
2022, Journal of the Formosan Medical AssociationCitation Excerpt :In the present study, we found no significant difference in the rate of pRBC transfusion before the 21st day of life between the 20-cm C-UCM and ICC groups, as well as hemoglobin and hematocrit levels at admission and the need for administration of volume expander within 24 h of life. This finding was similar to the reports by Ümmühan et al., Simonin et al., and Hasan et al.,8–10 whereas three other studies reported the opposite.5–7 A possible reason for this discrepancy is that the length of the umbilical cord milked in the present study was shorter than that in previous studies, which was the purpose of this study.
Perinatal care for the extremely preterm infant
2022, Seminars in Fetal and Neonatal MedicineCitation Excerpt :UCM consists of gentle stripping of the umbilical cord from the placental end toward the infant, usually in a time frame of 20–30 s and then clamping the cord [121,132]. While UCM is usually performed before clamping the umbilical cord (intact UCM), milking after clamping and cutting of the umbilical cord (cut UCM) has also been reported [133]. UCM has been considered as an alternative to DCC in such situations for term or late preterm infants when DCC could be difficult to implement in infants who require immediate resuscitation at birth [134,135].
The authors report no conflict of interest.
Cite this article as: Upadhyay A, Gothwal S, Parihar R, et al. Effect of umbilical cord milking in term and near term infants: randomized control trial. Am J Obstet Gynecol 2013;208:120.e1-6.