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Safety of umbilical cord milking in very preterm neonates: a randomized controlled study

대한산부인과학회지 2017년 60권 6호 p.527 ~ 534
Song Soo-Youn, 김유진, 강병헌, Yoo Heon-Jong, 이미나,
소속 상세정보
 ( Song Soo-Youn ) - Chungnam National University School of Medicine Chungnam National University Hospital Department of Obstetrics and Gynecology
김유진 ( Kim You-Jin ) - Chungnam National University School of Medicine Chungnam National University Hospital Department of Obstetrics and Gynecology
강병헌 ( Kang Byung-Hun ) - Chungnam National University School of Medicine Chungnam National University Hospital Department of Obstetrics and Gynecology
 ( Yoo Heon-Jong ) - Chungnam National University School of Medicine Chungnam National University Hospital Department of Obstetrics and Gynecology
이미나 ( Lee Mi-Na ) - Chungnam National University School of Medicine Chungnam National University Hospital Department of Obstetrics and Gynecology

Abstract


Objective: To investigate the safety of umbilical cord milking on both the mother and neonate among very preterm deliveries of less than 33 weeks of gestation.

Methods: Pregnant women who were expected to deliver at between 24 0/7 and 32 6/7 weeks of gestation were randomized to either the umbilical cord milking or immediate cord clamping group. Maternal and neonatal data associated with delivery, in addition to neonatal morbidity and mortality data, were collected and analyzed.

Results: Of the 66 preterm deliveries included in the study, 34 were randomized into the milking and 32 into the clamping group. Differences between maternal pre- and post-partum hemoglobin levels were 1.35 g/dL in the milking and 1.58 g/dL in the clamping group (P=0.451). Neonatal Apgar scores at both 1 and 5 minutes, initial blood gas analysis results, body temperature at admission, need for early intubation, and maximum bilirubin levels were all similar between the 2 groups. However, neonatal hemoglobin levels at birth (15.79 vs. 14.69 g/dL; P<0.05) and at 24 hours of age (14.83 vs. 13.29 g/dL; P<0.05) were significantly higher in the milking group. Neonates in the clamping group required more blood transfusion (1.78 vs. 0.93; P=0.049), and a higher percentage of neonates in the clamping group required inotropic drugs (63% vs. 29%; P=0.007). The mortality rate was significantly lower in the milking group (6% vs. 28%; P=0.015).

Conclusion: Umbilical cord milking can be a safe and beneficial procedure for both the mother and the neonate in deliveries of less than 33 weeks of gestation.

키워드

Fetomaternal transfusion; Anemia; neonatal; Infant; premature

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