The Effects of Umbilical Cord Milking on Hemodynamics and Neonatal Outcomes in Premature Neonates

Part 7: Neonatal Resuscitation

“…For the critical outcome of death, we found low-quality evidence (downgraded for very serious imprecision) from 3 randomized clinical trials [38][39][40] showing that there is no difference in death (OR, 0.76; 95% CI, 0.25-2.29).…”

“…For the critical outcome of cardiovascular stability, we found lowquality evidence (downgraded for imprecision) from 2 randomized studies 38,39 showing that the initial mean blood pressure was 5.43 mm Hg higher (range, 1.98-8.87 mm Hg) in the group receiving umbilical cord milking.…”

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

“…Blood volume assessment can be done with either biotin labeling or red cells method, which is time consuming, expensive and difficult to perform on a large number of neonates or diluting adult hemoglobin in fetal blood and comparing this with circulating fetal hemoglobin, which is limited to neonates who require a donor blood transfusion (23,25) . Due to these limitations we adhered to measurements in venous Hb and HCT .…”

Umbilical Cord Milking Versus Delayed Cord Clamping in Preterm Infants

“…This procedure can be performed within 20 seconds. 6 A recent meta-analysis of 7 randomized controlled trials of UCM in infants delivered at ,33 weeks demonstrated that infants who undergo UCM have higher hemoglobin (Hb) and a lower risk for oxygen requirement at 36 weeks and IVH of all grades compared with those who undergo immediate cord clamping (ICC). 7 A recently published study compared UCM with DCC (n = 58) in infants delivered at ,33 weeks' gestational age.…”

“…20 Although there are limited data on neurodevelopmental outcomes in premature infants, 21 UCM has been studied in 7 randomized controlled trials and 9 controlled trials over the past 60 years in term and preterm infants (n = 1904), documenting its safety and efficacy. 6,20,[22][23][24][25][26][27][28][29][30][31] A recent metaanalysis evaluating the safety and efficacy of UCM at birth concluded that there was a lower risk for oxygen requirement at 36 weeks and IVH of all grades. 7 Therefore, UCM should no longer be considered experimental; rather, it is a proven intervention that ensures that premature newborns receive an adequate placental transfusion at birth.…”