Ryan M McAdams1,2, Emily Fay3, Shani Delaney3. 1. Department of Pediatrics, University of Washington, Seattle, WA, USA. mcadams@pediatrics.wisc.edu. 2. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. mcadams@pediatrics.wisc.edu. 3. Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
Abstract
OBJECTIVE: The objective of this study is to determine placental transfusion blood volumes with intact and cut umbilical cord milking in term newborns. STUDY DESIGN: Sixty women at ≥37 weeks' gestation were enrolled. Following delivery, the umbilical cord was immediately clamped and cut to separate the newborn. Either intact umbilical cord milking (I-UCM) of the placental-umbilical cord unit or cut umbilical cord milking (C-UCM) of the cut umbilical cord segment was performed. For I-UCM, the cord underwent milking three or four times while being attached to placental circulation. For C-UCM, a 10, 20, or 30 cm cord segment was cut separately and milked four times. Blood volumes were compared between I-UCM and C-UCM methods. RESULTS: Mean blood volume with I-UCM (×4) was increased compared to the 30 cm C-UCM technique (48.5 ± 19.0 vs. 24.8 ± 4.0 mL, P < 0.001). For C-UCM, blood volume increased proportionally to cord length and, by the second milking, 98.1 ± 4.5% of blood volume was delivered. CONCLUSION: I-UCM provides a greater blood volume than C-UCM. With C-UCM, milking the cord more than twice offers no additional advantage.
OBJECTIVE: The objective of this study is to determine placental transfusion blood volumes with intact and cut umbilical cord milking in term newborns. STUDY DESIGN: Sixty women at ≥37 weeks' gestation were enrolled. Following delivery, the umbilical cord was immediately clamped and cut to separate the newborn. Either intact umbilical cord milking (I-UCM) of the placental-umbilical cord unit or cut umbilical cord milking (C-UCM) of the cut umbilical cord segment was performed. For I-UCM, the cord underwent milking three or four times while being attached to placental circulation. For C-UCM, a 10, 20, or 30 cm cord segment was cut separately and milked four times. Blood volumes were compared between I-UCM and C-UCM methods. RESULTS: Mean blood volume with I-UCM (×4) was increased compared to the 30 cm C-UCM technique (48.5 ± 19.0 vs. 24.8 ± 4.0 mL, P < 0.001). For C-UCM, blood volume increased proportionally to cord length and, by the second milking, 98.1 ± 4.5% of blood volume was delivered. CONCLUSION: I-UCM provides a greater blood volume than C-UCM. With C-UCM, milking the cord more than twice offers no additional advantage.
Authors: John Madar; Charles C Roehr; Sean Ainsworth; Hege Ersda; Colin Morley; Mario Rüdiger; Christiane Skåre; Tomasz Szczapa; Arjan Te Pas; Daniele Trevisanuto; Berndt Urlesberger; Dominic Wilkinson; Jonathan P Wyllie Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.892