University of Sussex
Browse

File(s) not publicly available

Milking compared with delayed cord clamping to increase placental transfusion in preterm neonates: a randomized controlled trial

journal contribution
posted on 2023-06-08, 13:24 authored by Heike RabeHeike Rabe, Amanda Jewison, Ramon Fernandez Alvarez, David Crook, Denise Stilton, Robert Bradley, Desmond Holden
OBJECTIVE To compare two strategies to enhance placento-fetal blood transfusion in preterm neonates before 33 weeks of gestation. METHODS We recruited women at risk for singleton preterm deliveries. All delivered before 33 completed weeks of gestation. In this single-center trial, women were randomized to either standard treatment (clamping the cord for 30 seconds after delivery) or repeated (four times) milking of the cord toward the neonate. Exclusion criteria included inadequate time to obtain consent before delivery, known congenital abnormalities of the fetus, Rhesus sensitization, or fetal hydrops. RESULTS Of 58 neonates included the trial, 31 were randomized to cord clamping and 27 were randomized to repeated milking of the cord. Mean birth weight was 1,263±428 g in the clamping group and 1,235±468 g in the milking group, with mean gestational age of 29.2±2.3 weeks and 29.5±2.7 weeks, respectively. Mean hemoglobin values for each group at 1 hour after birth were 17.3 g/L for clamping and 17.5 g/L for milking (P=.71). There was no significant difference in number of neonates undergoing transfusion (clamping group, 15; milking group, 17; P=.40) or the median number of transfusions within the first 42 days of life (median [range]: clamping group 0 [0-7]; milking group 0 [0-20]; P=.76). CONCLUSION Milking the cord four times achieved a similar amount of placento-fetal blood transfusion compared with delaying clamping the cord for 30 seconds. CLINICAL TRIAL REGISTRATION National Research Register UK, www.nihr.ac.uk/Pages/default.aspx, N0051177741. LEVEL OF EVIDENCE I.

History

Publication status

  • Published

Journal

Obstetrics and gynecology

ISSN

1873-233X

Publisher

WOlters Kluwer

Issue

2 Pt 1

Volume

117

Page range

205-211

Department affiliated with

  • Clinical and Experimental Medicine Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2012-11-14

Usage metrics

    University of Sussex (Publications)

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC