The Hematologic Impact of Umbilical Cord Milking Versus Deferred Cord Clamping in Premature Neonates.

Zagazig University

Status: Completed

Conditions: Umbilical Cord Milking; Delayed Cord Clamping; Preterm Neonates

Treatments: Procedure: cord milking; Procedure: delayed cord clamping

Study type: Interventional

Funder types: Other

Identifiers

NCT03147846

milking vs delayed clamping

Details and patient eligibility

About

Comparing the beneficial effect of cord milking versus deferred cord clamping in preterm neonates. A randomized controlled trial

Full description

Placental transfusion either by deferred cord clamping or umbilical cord milking became standard care and recommended management especially in preterm deliveries.1 In average, about 80 ml of blood was found to be transferred to the neoborn by one minute after birth.2 This additional blood can afford extra iron and blood volume giving the benefit of less iron deficiency anemia during the first year of life, less need for blood transfusion, less need for vasopressors and less intraventricular hemorrhage (IVH) by 50%.3 Placental transfusion with different techniques proved safety with no significant risks regarding postpartum hemorrhage, polycythemia, jaundice, Apgar score or admission rates.4 Our study aims to compare delayed cord clamping with umbilical cord milking as the best way for placental transfusion for preterm neonates.

Enrollment: 200 patients

Sex: All

Ages: 24 to 35 weeks old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Gestational age 24 to 34+6 weeks

Exclusion criteria

• Category III CTG
• Monochorionic twins
• Significant antepartum hemorrhage
• IUGR or Rh incompatibility

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Double Blind

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200 participants in 2 patient groups

delayed cord clamping

Experimental group

Description:

Keep the baby at the level or below the placenta for 45-60 seconds before clamping the cord. Keep the room temperature at 23-25˚C and wrap the baby if possible

Treatment:

Procedure: delayed cord clamping

cord milking

Active Comparator group

Description:

Do 4-5 strips from proximal (maternal) end of the cord (as proximal as possible) towards the baby abdomen with thumb and forefinger Wait for 2 seconds between each stripping Keep the baby at the level of placenta

Treatment:

Procedure: cord milking