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

Journal of Perinatology volume 38, pages 245–250 (2018)Cite this article

Subjects

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.

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Fig. 1: Total milked cord blood volume.
Fig. 2: Total milked cord blood volume per newborn birth weight

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Acknowledgements

We gratefully acknowledge the technical assistance of Jan Hamanishi in preparing the figures and the statistical advice provided by Jens Eickhoff. There were no sources of funding for this project. Data from this study were presented as a poster at the ACOG Annual Clinical and Scientific Meeting in San Diego, CA, in May 2017 and the Pediatric Academic Society Meeting in San Francisco, CA, in May 2017.

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Authors and Affiliations

  1. Department of Pediatrics, University of Washington, Seattle, WA, USA

    Ryan M. McAdams

  2. Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA

    Emily Fay & Shani Delaney

  3. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Ryan M. McAdams

Authors
  1. Ryan M. McAdams
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  2. Emily Fay
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Correspondence to Ryan M. McAdams.

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The authors declare that they have no competing financial interest.

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McAdams, R.M., Fay, E. & Delaney, S. Whole blood volumes associated with milking intact and cut umbilical cords in term newborns. J Perinatol 38, 245–250 (2018). https://doi.org/10.1038/s41372-017-0002-x

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