Milking Versus Delayed Cord Clamping in Full Term Neonates

Ahmed Mohamed El Kotb Abdel Fattah300 enrolled

Overview

To compare the short term risks and benefits of cord milking 5 times toward the neonate with delayed cord clamping for 120 seconds in the full term neonate delivered by cesarean section.

Abstract Context: milking of the umbilical cord toward the neonate 5 times and delayed cord clamping both are good procedures to prevent anemia in neonates . Objective: To investigate the effects of delayed umbilical cord clamping for 120 seconds, compared with milking of the cord 5 times toward the neonate on hemoglobin level after 6 weeks, Intubation,Respiratory distress,Clinical jaundice,Neonatal Intensive Care unit (NICU) admission,Apgar score (after 5 minutes of delivery). -Maternal,Need for blood transfusion,Additional need for therapeutic uterotonics,Post postpartum hemorrhage (blood loss \> 500cc),Intensive Care unit admission. Design: Randomized controlled trial. Setting: Ain Shams university maternity hospital. Participants:300 full term infants born after a low risk pregnancy by cesarean section delivery. Intervention: Infants were randomized to delayed umbilical cord clamping (≥120 seconds after delivery) or cord milking (5 times to ward the neonate).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

300

Conditions

Neonatal Anemia

Interventions

cord milkingPROCEDURE

milking of the cord 5 times toward the neonate

delayed cord clampingPROCEDURE

delay clamping of the cord for 120 seconds

Eligibility

Sex: FEMALE

Medical Language ↔ Plain English

Inclusion Criteria: * Pregnant females going for cesarean section that completed 37 weeks of gestation * Medically free Exclusion Criteria: * Known congenital anomalies of fetus. * Rhesus sensitization. * Fetal hydrops. * Medical disorder (preeclampsia - diabetes mellitus - hypertension - SLE). * Need for urgent resuscitation. * Multiple pregnancies.

Locations (1)

Ain Chams University Maternity Hospital

Cairo, Cairo Governorate, Egypt

Outcomes

Primary Outcomes

Neonatal Hemoglobin Level

neonatal 6 weeks hemoglobin measured in gram %

Time frame: 6 weeks after labor

Secondary Outcomes

Jundice Requring Phtotherapy

number of infants requiring phtotherapy for jundice in the first 2 weeks

Time frame: two weks

Severe Postpartum Haemorrage

(measured blood loss 1000 mL or more

Time frame: 24 hours after labor

Neonatal Intubation

number of newborns requirng intubation in the first 2 hours after delivery

Time frame: 1st 2 hours after delivery

Neonatal Intensive Care Unit (NICU) Admission

number of Neonatal Intensive Care unit (NICU) admission in the 1st 24 hours after delivery

Time frame: 1st 24 hours after delivery

Neonatal Apgar Score (After 5 Minutes of Delivery).

* The Apgar test is done by a doctor, midwife, or nurse. The health care provider examines the baby's: 1. Breathing effort 2. Heart rate 3. Muscle tone 4. Reflexes 5. Skin color * Each category is scored with 0, 1, or 2, depending on the observed condition. * The Apgar score is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth. * A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth. * Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs

Time frame: 5 minutes of delivery

Data from ClinicalTrials.gov

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