Effects of Placental Transfusion by Delayed Cord Clamping or Umbilical Cord Milking versus Immediate Cord Clamping on Neonatal Outcomes in Very Low Birth Weight Neonates
Background: Delayed cord clamping (DCC) and umbilical cord
milking (UCM) are two recently advocated interventions to enhance placental
transfusion at birth. DCC and MCM might increase blood volume and help neonates
to transition from fetal to neonatal circulation. Objective: To evaluate the
effects of delayed cord clamping (DCC), umbilical cord milking (UCM), and
immediate cord clamping (ICC) on very low birth weight (VLBW) neonates. Methods:At our institution, ICC was routinely done until
December, 2012 when it was replaced by DCC. UCM was implemented in March, 2015.
Neonatal outcomes were compared among ICC, DCC, and UCM. Results: A total of 94 neonates met inclusion criteria.
Comparing with ICC neonates, DCC and UCM neonates had higher hematocrits, fewer
blood transfusions, and lower incidence of chronic
lung disease at 36 completed weeks of gestation. All groups were similar in APGAR
scores, vasopressor use, intraventricular hemorrhage (IVH) and necrotizing
enterocolitis (NEC). Conclusion: Compared to ICC, DCC and UCM appear to be more
beneficial to VLBW neonates without apparent adverse risks.
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