Whole blood volumes associated with milking intact and cut umbilical cords in term newborns

Abstract

Objective: The objective of this study is to determine placental transfusion blood volumes with intact and cut umbilical cord milking in term newborns.

Study design: Sixty women at ≥37 weeks' gestation were enrolled. Following delivery, the umbilical cord was immediately clamped and cut to separate the newborn. Either intact umbilical cord milking (I-UCM) of the placental-umbilical cord unit or cut umbilical cord milking (C-UCM) of the cut umbilical cord segment was performed. For I-UCM, the cord underwent milking three or four times while being attached to placental circulation. For C-UCM, a 10, 20, or 30 cm cord segment was cut separately and milked four times. Blood volumes were compared between I-UCM and C-UCM methods.

Results: Mean blood volume with I-UCM (×4) was increased compared to the 30 cm C-UCM technique (48.5 ± 19.0 vs. 24.8 ± 4.0 mL, P < 0.001). For C-UCM, blood volume increased proportionally to cord length and, by the second milking, 98.1 ± 4.5% of blood volume was delivered.

Conclusion: I-UCM provides a greater blood volume than C-UCM. With C-UCM, milking the cord more than twice offers no additional advantage.