Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial

Yadav, Ajeet Kumar; Upadhyay, Amit; Gothwal, Sunil; Dubey, Kirti; Mandal, Uday Kumar; Yadav, Chander Prakash

doi:10.1038/jp.2015.65

Cited by 30 publications

(40 citation statements)

References 33 publications

(37 reference statements)

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“…7 However the methods of cord milking varied across studies, while Hosono et al and Katheria et al milked 2-3times at a speed of 20cm/ 2sec. [15][16][17][18][19] All the studies have milked the cord before clamping except Upadhay et al, Kumar et al, Prateek et al that milked the cord 3 times after clamping. 7,20,21 Authors chose the technique used by Kumar et al where the cord is clamped at a distance of 25 cm and only that segment of the cord is milked three times.…”

Section: Discussionmentioning

confidence: 99%

A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

Devadas

Roshni

Mallesh

2020

Int J Contemp Pediatr

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Background: Perinatal iron deficiency has received little attention in the past. Umbilical cord milking is a type of placental transfusion, they serve to potentially enhance neonatal blood volume and consequently the iron stores after birth. Among the neonates, the preterm infants are sick and vulnerable babies who are already deprived of iron stores. The aim of this study was to evaluate the effect of cord milking on ferritin values amongst preterm neonates.Methods: This is a hospital based randomized control trial which included the babies born at 29-36 weeks of gestation. The babies were randomized to two intervention groups; cord milking and delayed cord clamping group. Detailed clinical history taken, including details of labour and clinical examination. Blood samples were analysed for ferritin as required at 6 weeks of post-natal age.Results: Neonates under cord milking group had higher ferritin values (249.04±21.93 ng/mL) as compared to those neonates under delayed cord clamping group (179.66±32.94 ng/mL) and this was statistically very significant (p= <0.001).Conclusions: In preterm neonates, umbilical cord milking results in improved iron status as shown by higher ferritin values at 6 weeks of life. UCM can be a used as placental transfusion strategy in preterm neonates for improving iron status and preventing anemia of prematurity.

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Section: Discussionmentioning

confidence: 99%

A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

Devadas

Roshni

Mallesh

2020

Int J Contemp Pediatr

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“…Si bien la incidencia de policitemia e hiperbilirrubinemia fue ligeramente superior en el grupo de pacientes con ordeño, no hubo una diferencia significativa entre ambos grupos y esas alteraciones fueron leves porque se corrigieron con procedimientos sencillos, como el incremento del aporte de líquidos intravenosos y la fototerapia. Estos hallazgos son similares a los encontrados por March y su grupo 21 en recién nacidos pretérmino y Erickson-Owens 24 y Yadav y colaboradores 28 en recién nacidos a término. Con base en ellos, la policitemia y la ictericia no contraindican el ordeño de cordón, sobre todo tomando en cuenta que son leves, se pueden tratar fácilmente en centros hospitalarios provistos del equipo y la tecnología necesarios, que es donde habitualmente nacen estos pacientes.…”

Section: Discussionunclassified

Eficacia del ordeño del cordón umbilical comparado con el pinzamiento temprano para prevenir la anemia en recién nacidos prematuros

et al. 2019

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OBJETIVO: Evaluar la eficacia del ordeño del cordón umbilical comparado con el pinzamiento temprano para prevenir la anemia en niños prematuros.MATERIALES Y MÉTODOS: Ensayo clínico abierto, con asignación al azar a uno de dos grupos: pinzamiento temprano y ordeño de cordón umbilical. Parámetros de estudio: evaluación de la hemoglobina basal, requerimiento y cantidad de transfusiones, volumen sanguíneo total transfundido y frecuencia de reacciones adversas. Para la comparación de variables continuas se utilizó t de Student, U de Mann Whitney para variables no paramétricas y c2 para variables categóricas, además del análisis multivariado corregido para trasfusión ajustada al peso al nacer, comorbilidades, hemoglobina basal y tipo de procedimiento. Se consideró significativa la p < 0.05.RESULTADOS: Se estudiaron 91 pacientes, 46 (50.5%) en el grupo con ordeño y 45 (49.5%) en el grupo con pinzamiento temprano. La hemoglobina a las 24 horas de vida en el grupo con ordeño fue significativamente mayor: 17.08 ± 2 g/dL vs 14.74 ± 1,78 g/dL; p = 0.001. La frecuencia de anemia: 22 (47.8%) vs 33 (73.3%); p = 0.001, el requerimiento de transfusión:19 (41.3%) vs 31 (68.8%); p = 0.002, y el volumen medio transfundido: 18.2 ± 33.6 mL vs 35.3 ± 45 L; p = 0.04 fueron significativamente menores en el grupo con ordeño al compararlo con el pinzamiento temprano. No hubo diferencias en policitemia (p = 0.57); hiperbilirrubinemia (p = 0.81) y estancia hospitalaria (p = 0.21). La concentración de hemoglobina basal, el peso menor de 1000 gramos, la edad gestacional menor de 30 semanas y el pinzamiento temprano se relacionaron directamente con la necesidad de transfusión.CONCLUSIONES: El ordeño del cordón umbilical es un procedimiento efectivo y seguro para prevenir la anemia en los recién nacidos prematuros.

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“…The sample included 1845 newborns with GA between 34 6 and 41 6/7 weeks. The selected studies were conducted in the United States, 26 India, [27][28][29][30][31][32] Egypt, 33,34 and Italy. 35 The sample size of the studies ranged from 24 to 300 newborns.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…UCM was compared with DCC in six RCTs 28,29,[31][32][33][34] and ICC in four RCTs. 26,27,30,35 One RCT 28 included DCC as control and DCC with milking the cut cord (DCM). In this case, to carry out the meta-analysis, we only included data on the UCM and DCC groups and excluded data on the DCM group.…”

Section: Study Characteristicsmentioning

confidence: 99%

Effects of cord milking in late preterm infants and full‐term infants: A systematic review and meta‐analysis

Ortiz‐Esquinas¹,

Rodríguez‐Almagro

Gómez‐Salgado

et al. 2020

Birth

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Background Umbilical cord milking (UCM) consists of performing several milkings of the cord from the placenta to the newborn. The objective was to evaluate the effects of UCM on newborns ≥34 weeks’ gestation. Methods Searches were conducted in MEDLINE, EMBASE, CINAHL, the Cochrane Database of Clinical Trials, and the clinicaltrails.gov database for randomized clinical trials (RCT), with no time or language restrictions, and for articles that compared UCM with other strategies. The main results were initial hemoglobin and hemoglobin after 6 weeks. The data were collected by two reviewers and the quality of the studies was assessed using the Cochrane Manual methodology. Results The sample included 1845 newborns in 10 RCTs. The use of UCM in ≥34 weeks’ gestation newborns was not related to initial hemoglobin levels (pooled weighted mean difference: (PWMD = 0.40 g/L [−0.16 to 0.95]) or after 6 weeks (PWMD = 0.07 g/L [−0.29 to 0.27]). A reduction in hemoglobin levels was also observed at 6 weeks when the control group had undergone late clamping (PWDM = 0.16g/L [−0.26 to −0.06]). Conclusions UCM produced no differences in hematologic variables for newborns with ≥34 weeks of gestation relative to controls. However, a slight decrease in hemoglobin levels is observed at 6 weeks when the control group is made up of newborns with late clamping.

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Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial

Abstract: Delayed cord clamping with milking the cut cord improved iron stores at 6 weeks of age in term infants, then either of the two interventions alone.

Cited by 30 publications

References 33 publications

A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

Eficacia del ordeño del cordón umbilical comparado con el pinzamiento temprano para prevenir la anemia en recién nacidos prematuros

Effects of cord milking in late preterm infants and full‐term infants: A systematic review and meta‐analysis

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