Umbilical Cord Milking on the Reduction of Red Blood Cell Transfusion Rates in Infants

Completed · Not applicable

Conditions studied: Prematurity

In brief

Delayed cord clamp of at least 30 seconds in neonates under 37 weeks has shown that these infants have higher circulating blood volume in the first 24 hours, less need for blood transfusions, and less incidence of intraventricular hemorrhage. Delayed umbilical cord clamping has also been shown to increase the initial hematocrit and decrease the need for red blood cell (RBC) transfusions compared with no intervention in infants born between 27 and 33 weeks' gestation. However, a delay in cord clamping of 30-45 seconds may theoretically interfere with neonatal resuscitation. There have been few studies that addressed the active milking of the cord and its effect on neonatal resuscitation. Active milking of the umbilical cord towards the baby prior to clamping (rather than passive) should take less than 5 seconds to perform and should not interfere with neonatal resuscitation. Umbilical cord milking, as an alternative to delayed cord clamping, has been shown to increase the circulatory blood volume expressed as the hemoglobin value. Active milking of the cord prior to clamping, however, is not considered standard of care and only 1 Japanese randomized control study has reported that umbilical cord milking reduces the need for RBC transfusions, thus reducing the number of infants requiring a RBC transfusion as compared with control conditions. Our study aims to test the hypothesis that active milking of the umbilical cord will reduce the need for transfusion in preterm infants.

Key facts

Study ID

NCT01523769

Run by

Eastern Virginia Medical School

People needed

113

Starts

2009-09-01

Expected to finish

2011-11-01

Last updated by the study team

2012-02-01

Who can join

Age: 18 and older. Sex: female. Healthy volunteers: accepted.

You may qualify if…

• Singleton pregnancy
• Delivery anticipated between 24 and 28+6 weeks gestation
• There is enough time from admission to anticipated delivery to properly obtain consent from the patient

You may not qualify if…

• Multifetal gestation
• Antenatally diagnosed major congenital anomaly
• Known Rh sensitized pregnancy
• Hydrops fetalis (any etiology)
• Known positive maternal Parvovirus titers
• Elevated peak systolic velocity of the fetal Middle Cerebral Artery (MCA)
• Clinical suspicion of placental abruption at delivery due to excessive maternal bleeding or uterine hypertonicity
• Maternal age under 18

Where it is running

• Eastern Virginia Medical School — Norfolk, Virginia, United States

Full record on ClinicalTrials.gov

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