Delayed Cord Clamping Versus Cord Milking in Preterm Neonates

Abstract

Delayed cord clamping (DCC) in which clamping of cord is delayed by 30 to 180 seconds has shown to improve the hematological status in both preterm and term infants. Another technique, umbilical cord milking (UCM), consists of grasping the uncut umbilical cord and milking from placenta several times toward the infant. In contrast to DCC, cord milking provides a placental transfusion without resuscitation delay and can be completed as quickly as immediate cord clamping. We performed a randomized controlled clinical trial with non-inferiority framework between delayed cord clamping & umbilical cord milking in preterm neonates. Neonates admitted for delivery < 37 weeks gestational age (GA) confirmed by dates and third trimesteric ultrasound were included in our study. While those with known congenital anomalies of fetus (diagnosed by ultrasound) or evident multiple congenital anomalies, hydrops fetalis, uterine rupture, known recent maternal exposure to Parvovirus, infant of Rhesus (Rh) negative women and history of Rh iso-immunization were excluded from the study. Apgar score was recorded for every neonate at 1 and 5 minutes of resuscitation to assess transition and any need for further resuscitation measures.