The haemodynamic effects of umbilical cord milking in term infants: a randomised controlled trial

Abstract

INTRODUCTION Umbilical cord milking (UCM) is a method which allows for postnatal placental transfusion. Several benefits of this method have been demonstrated in studies. However, our knowledge about the haemodynamic effects of this method is limited among term infants. The aim of this study was to evaluate the haemodynamic effects of UCM in term infants. METHOD In this prospective randomised controlled study, 149 healthy term infants with a birth week of 37 weeks or more were randomised to either the UCM or immediate cord clamping (ICC) groups. Blinded echocardiographic evaluations were performed in all the neonates in the first 2 to 6 hours. RESULTS Superior vena cava (SVC) flow measurements were higher in the UCM group compared to the ICC group (132.47 ± 37.0 mL/kg/min vs. 126.62 ± 34.3 mL/kg/min), but this difference was not statistically significant. Left atrial diameter (12.23 ± 1.99 mm vs. 11.43 ± 1.78 mm) and left atrium-to-aorta diastolic diameter ratio (1.62 ± 0.24 vs. 1.51 ± 0.22) were significantly higher in the UCM group. There were no significant differences in other echocardiographic parameters between the UCM and ICC groups. CONCLUSION We found that no difference in the SVC flow measurements in term infants undergoing UCM. The lack of any significant difference in SVC flow may be explained by a mature cerebral autoregulation mechanism in term neonates.