Comparison of Umbilical Cord Milking and Delayed Cord Clamping on Cerebral Blood Flow in Term Neonates

Jaiswal, Prateek; Upadhyay, Amit; Gothwal, Sunil; Chaudhary, Hema; Tandon, Abhinav

doi:10.1007/s12098-015-1734-2

Cited by 38 publications

(32 citation statements)

References 18 publications

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“…This might explain higher mean Hb level in UCM group in trial carried out by Rabe et al 24 A similar trial from our institute also reported that Hb and hematocrit in initial 48 h were similar in UCM and DCC groups in full-term infants. 26 Ceriani et al 31 demonstrated that 3 min of DCC in term infants improved serum ferritin level at 6 months of age without any significant change in mean Hb level, which was similar to our primary outcome at 6 weeks of age in DCC group. However, this effect of DCC did not last till 12 months of age as demonstrated by Andersson et al 32 in 382 full-term infants that iron status and neurodevelopmental outcomes were similar in DCC (⩾180 s) and early cord clamping group (⩽10 s).…”

Section: Discussionsupporting

confidence: 85%

“…Standard technique of milking the cut cord was demonstrated by online video by William Tarnow Mordi et al 25 Obstetricians were sensitized enough regarding position of the baby in cesarean and vaginal delivery as well as their role during different interventions as they were a part of similar studies at our institute. 23,26 Just after delivery, depending upon random number slips, participants were allocated one of the three intervention groups, that is, milking the cut cord (UCM), DCC and DCC with milking the cut cord (DCM). In UCM group, just after delivery, umbilical cord was clamped and cut immediately (⩽10 s) at placental end leaving cord length of at least 25 cm from the umbilicus of baby.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial

et al. 2015

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial

et al. 2015

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“…There was no significant difference in polycythemia, serum bilirubin, and need of phototherapy between groups. Jaiswal et al compared C-UCM to DCC of 60–90 s (100 in each group) in babies born >36 weeks gestational age (55). Mean serum ferritin at 6 weeks of age in the C-UCM group (134.0 ± 89.8 ng/ml) was comparable to DCC (142.7 ± 87.1 ng/ml).…”

Section: Methods Of Providing a Placental Transfusionmentioning

confidence: 99%

Providing a Placental Transfusion in Newborns Who Need Resuscitation

et al. 2017

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Over the past decade, there have been several studies and reviews on the importance of providing a placental transfusion to the newborn. Allowing a placental transfusion to occur by delaying the clamping of the umbilical cord is an extremely effective method of enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. However, premature and term newborns who require resuscitation have impaired transitional hemodynamics and may warrant different methods to actively provide a placental transfusion while still allowing for resuscitation. In this review, we will provide evidence for providing a placental transfusion in these circumstances and methods for implementation. Several factors including cord clamping time, uterine contractions, umbilical blood flow, respirations, and gravity play an important role in determining placental transfusion volumes. Finally, while many practitioners agree that a placental transfusion is beneficial, it is not always straightforward to implement and can be performed using different methods, making this basic procedure important to discuss. We will review three placental transfusion techniques: delayed cord clamping, intact umbilical cord milking, and cut-umbilical cord milking. We will also review resuscitation with an intact cord and the evidence in term and preterm newborns supporting this practice. We will discuss perceived risks versus benefits of these procedures. Finally, we will provide key straightforward concepts and implementation strategies to ensure that placental-to-newborn transfusion can become routine practice at any institution.

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“…Este procedimiento puede tener efectos similares al pinzamiento tardío del cordón umbilical en prevención de anemia, reducción de hemorragia intraventricular, sepsis, enterocolitis necrosante, retinopatía del prematuro y displasia broncopulmonar. [10][11][12][13][14] A diferencia del pinzamiento tardío, el ordeño del cordón no retrasa el proceso de reanimación neonatal, sobre todo en prematuros críticamente enfermos, lo que puede constituir una ventaja para este procedimiento. 15 El pinzamiento temprano del cordón umbilical; es decir, antes de los 30 segundos de vida, aún es una práctica habitual en nuestro medio asociada con una serie de complicaciones en el recién nacido, incluida la mayor frecuencia de anemia.…”

Section: Discussionunclassified

Eficacia del ordeño del cordón umbilical comparado con el pinzamiento temprano para prevenir la anemia en recién nacidos prematuros

et al. 2019

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OBJETIVO: Evaluar la eficacia del ordeño del cordón umbilical comparado con el pinzamiento temprano para prevenir la anemia en niños prematuros.MATERIALES Y MÉTODOS: Ensayo clínico abierto, con asignación al azar a uno de dos grupos: pinzamiento temprano y ordeño de cordón umbilical. Parámetros de estudio: evaluación de la hemoglobina basal, requerimiento y cantidad de transfusiones, volumen sanguíneo total transfundido y frecuencia de reacciones adversas. Para la comparación de variables continuas se utilizó t de Student, U de Mann Whitney para variables no paramétricas y c2 para variables categóricas, además del análisis multivariado corregido para trasfusión ajustada al peso al nacer, comorbilidades, hemoglobina basal y tipo de procedimiento. Se consideró significativa la p < 0.05.RESULTADOS: Se estudiaron 91 pacientes, 46 (50.5%) en el grupo con ordeño y 45 (49.5%) en el grupo con pinzamiento temprano. La hemoglobina a las 24 horas de vida en el grupo con ordeño fue significativamente mayor: 17.08 ± 2 g/dL vs 14.74 ± 1,78 g/dL; p = 0.001. La frecuencia de anemia: 22 (47.8%) vs 33 (73.3%); p = 0.001, el requerimiento de transfusión:19 (41.3%) vs 31 (68.8%); p = 0.002, y el volumen medio transfundido: 18.2 ± 33.6 mL vs 35.3 ± 45 L; p = 0.04 fueron significativamente menores en el grupo con ordeño al compararlo con el pinzamiento temprano. No hubo diferencias en policitemia (p = 0.57); hiperbilirrubinemia (p = 0.81) y estancia hospitalaria (p = 0.21). La concentración de hemoglobina basal, el peso menor de 1000 gramos, la edad gestacional menor de 30 semanas y el pinzamiento temprano se relacionaron directamente con la necesidad de transfusión.CONCLUSIONES: El ordeño del cordón umbilical es un procedimiento efectivo y seguro para prevenir la anemia en los recién nacidos prematuros.

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Comparison of Umbilical Cord Milking and Delayed Cord Clamping on Cerebral Blood Flow in Term Neonates

Abstract: DCC and UCM had similar effect on cerebral blood flow velocities and Doppler indices in MCA, in term neonates.

Cited by 38 publications

References 18 publications

Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial

Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial

Providing a Placental Transfusion in Newborns Who Need Resuscitation

Eficacia del ordeño del cordón umbilical comparado con el pinzamiento temprano para prevenir la anemia en recién nacidos prematuros

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