Delayed Cord Clamping Versus Umbilical Cord Milking in Term and Near-Term Neonates- A Randomized Controlled Trial

Aim: To compare the effect of delayed cord clamping versus milking of umbilical cord on initial hematocrit in term and near-term neonates. Methods : This randomized controlled trial included 374 pregnant women of more than 34 weeks period of gestation. They were randomized into umbilical cord milking group and delayed cord clamping group. In umbilical cord milking group, 119 underwent vaginal delivery and 68 underwent caesarean section. In delayed cord clamping group, 117 underwent vaginal delivery and 70 underwent caesarean section. Results : Mean hematocrit in cord sample was 47.02±7.13% in umbilical cord milking group and 48.04±8.36% in delayed cord clamping group and the difference was not statistically significant (p=0.21). Mean hematocrit at 30±6 hours was 54.48±5.84% in umbilical cord milking group and 50.9±7.1% in delayed cord clamping group and the difference was statistically significant(p=0.01). Requirement of phototherapy in umbilical cord milking group was 18.18% and in delayed cord clamping group was 19.25%(p=0.79). Rate of neonatal intensive care unit admissions was 2.67% in umbilical cord milking group and 7.49% in delayed cord clamping group(p=0.034). Conclusion : Umbilical cord milking lead to significant increase in hematocrit levels without increasing the requirement of phototherapy and neonatal intensive care unit admissions. Hence, umbilical cord milking can be used as an alternative to delayed cord clamping in both term and near-term neonates.