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Indian Pediatr 2021;58: 593 |
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Milking of Umbilical Cord vs Delayed Cord
Clamping
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Parvathi Jayaprakash and Babu S Madarkar*
Department of Neonatology, Rainbow Children’s Hospital,
Bengaluru 560037, Karnataka.
Email:
[email protected]
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We read the article by Mangla, et al.
[1] which deserves appreciation for the novelty of the topic. We
seek clarifications on following issues:
i) In the study outcome, hematocrit
values differ by mere 1.8% and 0.8% at 48±6 hours and at 6
weeks, respectively. This seems to be clinically
insignificant, consequently not requiring any interventions.
ii) In babies delivered by caesarean
section, anesthesia and surgical interventions interferes
with active uterine contraction leading to more blood volume
remaining in placenta. Hence, cord will not be refilled
after first milking maneuver [2], leading to inefficiency of
umbilical cord milking.
iii) At high altitudes [3], infants
born to mothers with anemia have higher hematocrits than
those born to non-anemic mothers, these factors were not
considered while interpreting secondary outcome at 6 weeks
of life. Many other studies showed contradictory findings
such as no difference on neonatal and maternal outcomes at
the age of 48-72 hours in term neonates [4].
We feel that the findings of this study
cannot be used to promote umbilical cord milking over delayed
cord clamping due to the above noted gaps.
REFERENCES
1. Mangla MK, Thukral A, Sankar MJ, et al.
Effect of umbilical cord milking vs delayed cord clamping on
venous hematocrit at 48 hours in late preterm and term neonates:
A randomized controlled trial. Indian Pediatr. 2020;57:1119-123.
2. Aladangady N, McHugh S, Aitchison TC, et
al. Infant’s blood volume in a controlled trial of placental
transfusion at preterm delivery. Pediatrics. 2006;117:93-8.
3. Ramirez-Cardich ME, Saito M, Gilman RH, et
al. Effect of maternal anemia at high altitude on infant
hematocrit and oxygenation. Am J Trop Med Hyg. 2004;70:420-4.
4. Panburana P, Odthon T, Pongmee P, et al. The Effect of
umbilical cord milking compared with delayed cord clamping in
term neonates: A randomized controlled trial. Int J Womens
Health. 2020;12:301-06.
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