Abstract
Objective We evaluated whether intact umbilical cord milking (UCM) is more effective than immediate
cord clamping (ICC) in enhancing placental transfusion after elective cesarean delivery.
Study Design In a randomized trial, volume of placental transfusion was assessed by Δ hematocrit
(Hct) between neonatal cord blood and capillary heel blood at 48 hours of age, corrected
for the change in body weight.
Results There were no significant differences in cord blood mean Hct values at birth (UCM,
44.5 ± 4.8 vs. ICC, 44.9 ± 4.2%, p = 0.74). Conversely, at 48 hours of age, the UCM group had significantly higher capillary
heel Hct values (UCM, 53.7 ± 5.9 vs. ICC, 49.8 ± 4.6%, p < 0.001), supporting a higher placental transfusion volume (Δ Hct, UCM 9.2 ± 5.2
vs. ICC 4.8 ± 4.7, p < 0.001), despite comparable neonatal body weight decrease (UCM, −7.3 vs. ICC, −6.8%,
p = 0.77).
Conclusion Higher Δ Hct between cord blood at birth and capillary heel blood at 48 hours of
age, corrected for the change in body weight, suggests that intact UCM is an efficacious
and safe procedure to enhance placental transfusion among neonates born via elective
cesarean delivery.
Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT03668782.
Keywords
neonatal anemia - elective cesarean section - newborns - umbilical cord milking -
placental transfusion
