Comparative Outcomes Related to Delivery-room Cord Milking In Low-resourced Kountries- PreTerm

Browse trials for

• Premature Birth 2,546
• Infant Death 56
• Fetofetal Transfusion 30

Keywords

• Preterm
• Umbilical cord milking
• Placental transfusion

Study arms

• Active comparator
  Umbilical Cord Milking

  The delivering practitioner will place the newborn below the level of the incision (at the edge of the table) at C/S and a second team member will milk the cord four times. For vaginal delivery, the delivering obstetrician, midwife or perinatal provider will hold the infant against their body or place the infant on the mother's abdomen and the cord will be milked either four times by the obstetrical provider or by a second team member. For the cord milking procedure, the obstetrical provider will milk 20-30 centimeters length of the umbilical cord over two seconds, repeating three additional times as described previously. This time is not significantly different from the time for early cord clamping (ECC).

  Procedure: Umbilical cord milking

• No intervention
  Early Cord Clamping

  Umbilical cord will be clamped immediately after birth (within 60 seconds)

Interventions

• ProcedureUmbilical cord milking

  At delivery, the umbilical cord is grasped, and blood is pushed toward the infant 4 times before the cord is clamped. This procedure infuses a placental transfusion of blood into the infant and can be done in 1--15 seconds.

  Also known as: UCM

Primary outcomes

1. In-hospital mortality

   Death of a baby during birth hospitalization

   Time frame: From date of birth until the date of discharge from the hospital or date of death from any cause, whichever come first, assessed up to 12 weeks

Secondary outcomes

1. Hemoglobin at or after 24 hours

   Hb levels

   Time frame: Days 1-7

2. Early and late onset culture positive sepsis

   Number of infants with early onset or late onset sepsis

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

3. Any intraventricular hemorrhage (IVH) and severe IVH (grade 3 or 4)

   Number of infants with any IVH or severe IVH

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

4. Need for blood transfusion

   Number of infants received blood transfusion

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

5. Moderate to severe hypoxemic ischemic encephalopathy

   Number of infants with moderate to severe hypoxemic ischemic encephalopathy

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

6. Necrotizing enterocolitis (Bell's stage 2 or higher)

   Number of infants with necrotizing enterocolitis (Bell's stage 2 or higher)

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

7. Need for medications for hypotension

   Number of infants needed medications for hypotension

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

8. Need for phototherapy for jaundice

   Number of infants needed phototherapy for jaundice

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

9. Retinopathy of prematurity (ROP) requiring intervention

   Number of infants with ROP that required intervention

   Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

10. Length of hospitalization

    Number of days infants stayed in hospital

    Time frame: From date of birth until the date of discharge from the hospital, assessed up to 12 weeks.

Individual participant data

Plan to share: Yes