Premature babies can be very sick and have bleeding in the brain. Giving babies more blood before cutting the umbilical cord by delayed cord clamping or umbilical cord milking has been shown to reduce the risk of bleeding in the brain. This may be related to improving perfusion to the brain. However, some studies suggest that delayed cord clamping may not increase hemoglobin or blood volume in babies delivered by cesarean section. Milking the umbilical cord may give more blood in babies delivered by Cesarean Section may improve perfusion and reduce bleeding in the brain.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
197
Umbilical cord milked toward the neonate four times at a speed of 20cm/2seconds, prior to clamping and cutting umbilical cord. Procedure takes about 10-20 seconds.
Performed by positioning the baby 20 cm below the placenta for 45-60 seconds prior to umbilical cord clamping and cutting.
Loma Linda Medical Center
Loma Linda, California, United States
Sharp Mary Birch
San Diego, California, United States
University of California, San Diego
San Diego, California, United States
Superior Vena Cava Flow
Time frame: <12 hours of life
Delivery Room Interventions
Time frame: 10 minutes of life
Hemoglobin
Time frame: <1 hour
Hemoglobin
Time frame: 12 hours
Hemoglobin
Time frame: 4 weeks of life
Neurodevelopmental impairment 18-36 months
Time frame: 18-36 months
Severe intraventricular hemorrhage (grade 3 or 4)
Time frame: up to 24 weeks after birth
Phototherapy
Requirement and length of phototherapy
Time frame: up to 24 weeks after birth
Ionotropic support
Requirement and length of ionotropic support
Time frame: up to 24 weeks after birth
Neonatal intensive care unit (NICU) length of stay
Time frame: up to 24 weeks after birth
Necrotizing enterocolitis
Time frame: up to 24 weeks after birth
Number of blood transfusions while in the neonatal intensive care unit
Time frame: up to 24 weeks after birth
Ventilator time
Time frame: up to 24 weeks after birth
Apgar score <7 at 5 minutes
Time frame: at 5 minutes after birth
Umbilical cord pH < 7.0
Time frame: up to 30 minutes after birth
Blood pressure in first 2 hours of admission to neonatal intensive care unit
Time frame: 2 hours after birth
Polycythemia
Time frame: up to 24 hours of life
Neonatal death
Time frame: up to 24 weeks of life
Use of uterotonic agents
Time frame: up to 1 hour after birth
Peak transcutaneous and/or serum bilirubin concentrations
Time frame: up to 24 weeks after birt
Maternal hemoglobin
Time frame: within 48 hours after delivery
Intraventricular Hemorrhage detected on Head Ultrasound
Time frame: up to 24 weeks after birth
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