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Am J Perinatol 2021; 38(04): 392-397
DOI: 10.1055/s-0039-1697673
Original Article

A Randomized Controlled Trial of Intact Cord Milking versus Immediate Cord Clamping in Term Infants Born by Elective Cesarean Section

Vincenzo Zanardo
1   Division of Perinatal Medicine, Policlinico AbanoTerme, Abano Terme, Italy
,
Pietro Guerrini
1   Division of Perinatal Medicine, Policlinico AbanoTerme, Abano Terme, Italy
,
Lorenzo Severino
1   Division of Perinatal Medicine, Policlinico AbanoTerme, Abano Terme, Italy
,
Alphonse Simbi
1   Division of Perinatal Medicine, Policlinico AbanoTerme, Abano Terme, Italy
,
Matteo Parotto
2   Department of Anesthesiology, Toronto University, Toronto, Canada
,
Gianluca Straface
1   Division of Perinatal Medicine, Policlinico AbanoTerme, Abano Terme, Italy
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Abstract

Objective We evaluated whether intact umbilical cord milking (UCM) is more effective than immediate cord clamping (ICC) in enhancing placental transfusion after elective cesarean delivery.

Study Design In a randomized trial, volume of placental transfusion was assessed by Δ hematocrit (Hct) between neonatal cord blood and capillary heel blood at 48 hours of age, corrected for the change in body weight.

Results There were no significant differences in cord blood mean Hct values at birth (UCM, 44.5 ± 4.8 vs. ICC, 44.9 ± 4.2%, p = 0.74). Conversely, at 48 hours of age, the UCM group had significantly higher capillary heel Hct values (UCM, 53.7 ± 5.9 vs. ICC, 49.8 ± 4.6%, p < 0.001), supporting a higher placental transfusion volume (Δ Hct, UCM 9.2 ± 5.2 vs. ICC 4.8 ± 4.7, p < 0.001), despite comparable neonatal body weight decrease (UCM, −7.3 vs. ICC, −6.8%, p = 0.77).

Conclusion Higher Δ Hct between cord blood at birth and capillary heel blood at 48 hours of age, corrected for the change in body weight, suggests that intact UCM is an efficacious and safe procedure to enhance placental transfusion among neonates born via elective cesarean delivery.

Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT03668782.

Keywords

neonatal anemia - elective cesarean section - newborns - umbilical cord milking - placental transfusion


Publication History

Received: 29 May 2019

Accepted: 16 August 2019

Article published online:
10 October 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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