Original ArticleUmbilical Cord Milking Stabilizes Cerebral Oxygenation and Perfusion in Infants Born before 29 Weeks of Gestation
Section snippets
Methods
We evaluated 50 VLBW infants with a gestational age of <29 weeks and a birth weight of <1250 g, who were admitted to the neonatal intensive care unit of our institution between January 1, 2006 and December 31, 2009. Among the 50 subjects who were admitted after November 2007, 26 had umbilical cord milking, as milking management was introduced in our unit after November 1, 2007. However, as this procedure requires the presence of more than 3 doctors at birth, umbilical cord milking was not
Results
There were no significant differences in gestational age, birth weight, Apgar score at 1 minute, sex, cesarean delivery rate, antenatal steroid administration rate, or occurrence of premature rupture of the membranes between the 2 groups (Table I). The initial hemoglobin values in the milked group were significantly higher than for the control group. The initial MABP in the milked group was higher than for the control group. Urine output within 24 hours in the milked group was higher than for
Discussion
Recent randomized controlled studies have shown that umbilical cord milking facilitates the early stabilization of both blood pressure and urine output, as well as a reduced need for both red blood cell transfusion and circulatory and respiratory support in VLBW infants.10, 11 The present study also showed that the initial hemoglobin, MABP, and urine output levels within 24 hours in the milked group were higher, and the need for volume expansion was lower, than in the control group. Within 18
References (31)
- et al.
Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage
J Pediatr
(1990) - et al.
Left ventricular end-systolic wall stress-velocity of fiber shortening relation: a load-independent index of myocardial contractility
J Am Coll Cardiol
(1984) - et al.
Noninvasive pulsed Doppler determination of cardiac output in neonates and children
J Pediatr
(1982) Neurologic outcome of prematurity
Arch Neurol
(1998)- et al.
Low cerebral blood flow is a risk factor for severe intraventricular haemorrhage
Arch Dis Child Fetal Neonatal Ed
(1999) - et al.
Hemodynamic and antecedent risk factors of early and late periventricular/intraventricular hemorrhage in premature infants
Pediatrics
(2003) - et al.
Superior vena cava flow in newborn infants: a novel marker of systemic blood flow
Arch Dis Child Fetal Neonatal Ed
(2000) - et al.
Low superior vena cava flow and intraventricular haemorrhage in preterm infants
Arch Dis Child Fetal Neonatal Ed
(2000) - et al.
Changes in cerebral perfusion in extremely low birth weight infants during the first 72 hours after birth
Pediatr Res
(2010) - et al.
Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial
J Pediatr
(2006)
Early versus delayed umbilical cord clamping in preterm infants
Cochrane Database Syst Rev
Umbilical cord milking reduces the need for red cell transfusions and improves neonatal adaptation in infants born at less than 29 weeks' gestation: a randomised controlled trial
Arch Dis Child Fetal Neonatal Ed
Blood pressure and urine output during the first 120 h of life in infants born at less than 29 weeks' gestation related to umbilical cord milking
Arch Dis Child Fetal Neonatal Ed
Milking compared with delayed cord clamping to increase placental transfusion in preterm neonates: a randomized controlled trial
Obstet Gynecol
The effect of blood transfusion and haemodilution on cerebral oxygenation and haemodynamics in newborn infants investigated by near infrared spectrophotometry
Eur J Pediatr
Cited by (0)
The authors declare no conflicts of interest.