Umbilical cord milking reduces the need for red cell transfusions and improves neonatal adaptation in infants born at less than 29 weeks' gestation: a randomised controlled trial

Hosono, S.; Mugishima, H.; Fujita, H.; Hosono, A.; Minato, M.; Okada, T.; Takahashi, S.; Harada, K.
January 2008
Archives of Disease in Childhood -- Fetal & Neonatal Edition;Jan2008, Vol. 93 Issue 1, pF14
Academic Journal
Objective: To investigate the effects of umbilical cord milking on the need for red blood cell (ABC) transfusion and morbidity in very preterm infants. Patients and Methods: 40 singleton infants born between 24 and 28 weeks' gestation were randomly assigned to receive umbilical cord clamped either immediately (control group, n = 20) or after umbilical cord milking (milked group, n = 20). Primary outcome measures were the probability of not needing transfusion, determined by Kaplan-Meier analysis, and the total number of ABC transfusions. Secondary outcome variables were haemoglobin value and blood pressure at admission. Results: There were no significant differences in gestational age and birth weight between the two groups. The milked group was more likely not to have needed red cell transfusion (p = 0.02) and had a decreased number (mean (SD(( of RBC transfusions (milked group 1.7 (3.0) vs controls 4.0 (4.2); p = 0.02. The initial mean (SD) haemoglobin value was higher in the milked group (165 (14) g/l) than in the controls (141 (16) g/l); p<0.01. Mean (SD) blood pressure at admission was significantly higher in the milked group (34 (9) mm Hg) than in the controls 28 (8) mm Hg; p = 0.03). There was no significant difference in mortality between the groups. The milked group had a shorter duration of ventilation or supplemental oxygen than the control group. Conclusion: Milking the umbilical cord is a safe procedure, reducing the need for ABC transfusions, and the need for circulatory and respiratory support in very preterm infants.


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