Intact-umbilical cord milking (I-UCM) | Blood drained from 25 cm of cord by milking 4 times
Cut-umbilical cord milking (C-UCM) | Pediatrician milked entire contents from 25 cm of cord following clamping and cutting
Immediate cord clamping (ICC)
Umbilical cord blood arterial gases were obtained following delivery
Complete blood count (CBC) and total serum bilirubin (TSB) values were obtained from venous blood at 48 hours of life
Calculations based on ability to detect mean increase in Hb of 0.8 g/dL in neonates with umbilical cord milking
Two-tailed p-value of 0.05 with a power of 90%
Sample size estimated at 200 for each group, taking in to account loss to follow-up
Comparisons of hematological parameters in term and late-preterm infants at 48 hours of age
I-UCM: 197 infants
C-UCM: 190 infants
ICC: 200 infants
Birth, maternal and infant demographics between the groups were similar
Approximately 90% of deliveries were cesarean
Mean hemoglobin and hematocrit levels at 48 hours of age were higher in I-UCM group compared with the ICC group
There were no significant differences in hemoglobin and hematocrit level between the C-UCM vs I-UCM groups or the C-UCM vs ICC groups
There were no significant differences in leukocyte levels or mean TSB levels between the groups
The intact cord milking group, but not the cut cord milking group, had higher hemoglobin and hematocrit levels compared to the immediate cord clamping group
While there was no statistical difference in hemoglobin and hematocrit levels between the intact vs cut umbilical cord milking group, higher hematologic indices were also seen in the intact group vs the cut cord group
More studies are required to confirm whether intact cord milking may be superior to cut cord milking and to determine if there are any long-term effects of these different methods
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