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Comparison of Umbilical Cord Milking and Delayed Cord Clamping on Cerebral Blood Flow in Term Neonates

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Abstract

Objective

To compare the effect of umbilical cord milking (UCM) and delayed cord clamping (DCC) on cerebral blood flow in term neonates.

Methods

This randomized controlled trial was conducted at a teaching hospital in India during 2012 to 2013. Two hundred newborns (>36wk) were randomized to UCM and DCC groups. UCM was done on 25cm of cord length. In DCC group, clamping was delayed by 60 to 90s. Resistive Index (RI), Pulsatility Index (PI) and cerebral blood flow velocities of middle cerebral artery (MCA) were measured at 24 to 48h of life.

Results

Baseline characteristics and hemodynamic parameters were comparable. Mean PI [1.18 (0.26)] and RI [0.65 (0.08)] in UCM group was comparable to mean PI [1.18 (0.25)] and RI [0.65 (0.08)] in DCC group. The peak systolic velocity and end diastolic velocity (cm/s) of blood flow in MCA for UCM group were 34.94 (11.82) and 11.71 (4.75) respectively, while in DCC group they were 37.24 (12.63) and 13.07 (4.78) (p 0.23 and 0.07) respectively. Indices among growth retarded babies were not different.

Conclusions

DCC and UCM had similar effect on cerebral blood flow velocities and Doppler indices in MCA, in term neonates.

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Acknowledgments

The authors are thankful to all enrolled babies and their parents, on duty resident doctors and lab clinician and radiologists for helping in blood tests and doppler studies.

Contributions

PJ collected, analyzed and interpreted the data for the study, and drafted the manuscript. AU and SG conceptualized and designed the study, analyzed the data and revised the manuscript. PJ, AU and SG cross checked the data and helped in review of the literature. HC and AT conducted the cranial Doppler. Critical review was performed by all the authors. AU will act as guarantor for this study.

Conflict of Interest

None.

Source of Funding

Partially funded by ‘thesis/ research grant’ of Indian Council for Medical Research (ICMR).

Author information

Authors and Affiliations

  1. Department of Pediatrics, LLRM Medical College, Meerut, Uttar Pradesh, 250004, India

    Prateek Jaiswal, Amit Upadhyay & Sunil Gothwal

  2. Department of Radiodiagnosis, LLRM Medical College, Meerut, Uttar Pradesh, India

    Hema Chaudhary & Ashutosh Tandon

Authors
  1. Prateek Jaiswal
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  2. Amit Upadhyay
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  3. Sunil Gothwal
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  4. Hema Chaudhary
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  5. Ashutosh Tandon
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Corresponding author

Correspondence to Amit Upadhyay.

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Jaiswal, P., Upadhyay, A., Gothwal, S. et al. Comparison of Umbilical Cord Milking and Delayed Cord Clamping on Cerebral Blood Flow in Term Neonates. Indian J Pediatr 82, 890–895 (2015). https://doi.org/10.1007/s12098-015-1734-2

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  • DOI: https://doi.org/10.1007/s12098-015-1734-2

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