Comparison of Hematocrit and Serum Microbilirubin at 48 Hours of Age between Umbilical Cord Milking versus Early Cord Clamping in Term Neonates Delivered by Cesarean Section

Main Article Content

Wichan Kaewkhiew

Abstract

Background: Umbilical cord milking (UCM), in which cord blood is milked toward the baby, has been used to prevent anemia in infants with vaginal delivery. Its benefit compared with early cord clamping (ECC), in which the umbilical cord is clamped at 30 seconds after birth, in full-term neonates delivered by cesarean section is lacking.
Objective: To investigate the effect of UCM compared with 30-seconds ECC on hematocrit (Hct) and serum microbilirubin at 48 hours of age among term neonates delivered by cesarean section.
Materials and methods: A retrospective cohort study was conducted among 206 full-term neonates delivered by cesarean section in San Sai Community Hospital between October 2020 and January 2021. The cord of the UCM group was milked 3 times after cutting and clamping at 25 cm from the umbilicus, whereas in ECC group cord was clamped at 2-3 cm near the umbilicus and not milked. Both groups received similar routine care. Hct and serum microbilirubin were measured at 48 hours of age. Percentages of infants with anemia (Hct <45%) and polycythemia (Hct >65%) were calculated. Student t-test and Fisher’s exact test were used for statistical analysis.
Results: There were 96 neonates in UCM group and 110 in ECC group. In UCM group, the average maternal age was significant higher and the mean
gestational age was significant lower than those of ECC group. Hct level at 48 hours in UCM group was significant higher than the ECC group (50.4 ± 6.5% vs 48.3 ± 5.9%, p=0.016), but the microbilirubin level was not different (9.4 ± 2.1 vs 9.2 ± 2.1 mg/dl, p=0.505). Percentages of infants with anemia was slightly lower in the UCM group than the ECC group (17.7% vs 23.6%, p=0.309). No significant differences in percentages of infants with polycythemia or receiving phototherapy were found.
Conclusion: Umbilical cord milking in term neonates delivered by cesarean section could significantly increase the hematocrit level at 48 hours of age and trended to lower the percentage of infants with anemia, comparing with the early cord clamping method.

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Kaewkhiew , W. (2022). Comparison of Hematocrit and Serum Microbilirubin at 48 Hours of Age between Umbilical Cord Milking versus Early Cord Clamping in Term Neonates Delivered by Cesarean Section. Lampang Medical Journal, 42(2), 48–54. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/250586
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Original Article

References

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