Comparison of cut and intact cord milking regarding cerebral oxygenation, hemodynamic and hematological adaptation of term infants

Abstract

Objective

Although both delayed umbilical cord clamping and intact umbilical cord milking (I-UCM) provide the effective placental transfusion at birth, these procedures may not be used in neonates needing resuscitation. The aim of this study is to investigate the effect of cut umbilical cord milking (C-UCM), which permits resuscitation during an immediate transition period (ITP).

Methods

Sixty-two healthy term infants were randomly divided into C-UCM and I-UCM groups at birth. Approximately 30-cm length of cord was milked towards the baby 2–4 times within 20 seconds after birth in both C-UCM and I-UCM groups while the umbilical cord was cut in the former, and intact in the latter. Heart rate, arterial oxygen saturation (SpO₂), cerebral regional oxygen saturation (crSO₂) (2nd–15th min), blood pressure (BP) (within 15–30 min), residual placental blood volume (RPBV), and hemoglobin levels (at the sixth hour) were monitored during ITP.

Results

There were no significant differences in terms of mean gestational age (w) [(39.0 ± 1.2) versus (38.8 ± 1.1)], birth weight (g) [(3351.45 ± 254.30) versus (3256.94 ± 285.52)], Apgar scores at the 5th min (10 ± 0 versus 10 ± 0), first breathing time (sec) (5.4 ± 3.8 versus 5.7 ± 4.1), SpO₂, crSO₂, BP (mmHg) [(52.9 ± 6.9) versus (51.8 ± 5.7)], hemoglobin levels (g/dl) [(17.7 ± 1.8) versus (18.4 ± 1.4)], and RPBV (ml/kg) [(23.9 ± 4.7) versus (22.9 ± 5.4)] between C-UCM and I-UCM groups (p > .05).

Conclusion

This study showed that C-UCM is as effective as I-UCM on cerebral oxygenation, hemodynamic and hematological adaptation of term infants in ITP. We suggest that C-UCM can provide additional placental transfusion in term neonates exposed to early cord clamping.

Keywords:

• Cut umbilical cord milking
• intact umbilical cord milking
• neonate
• postnatal adaptation

Acknowledgements

We thank Hande Şenol from the Department of Statistics, Pamukkale University, Denizli for statistical analysis.

Disclosure of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by Science Research Project Coordination Unit of Pamukkale University [01/03/2018/TPF008].