Comparison Of Umbilical Cord Milking And Delayed Cord Clamping On Haemoglobin And Haematocrit Levels In Term Neonates. A Randomized Controlled Trial.

ABSTRACT

Background: Delayed umbilical cord clamping is an effective strategy and particularly relevant for infants living in low-resource settings with less access to iron-rich foods and thus are at greater risk of anaemia. Objective: To compare the effect of umbilical cord milking (UCM) and delayed cord clamping (DCC) on haematological parameters (serum ferritin & hemoglobin) at birth and at 72 hours in term neonates. Methods: This was an Open Label Randomized Controlled Trial conducted at Suvidha Mother and Child Nursing Home Talab Tillo Jammu over a period of 6 months. A total of 68 babies born at > 37 weeks of gestation were randomized in three groups, group I UCM alone (n=28) , Group II DCC alone (n=23) and Group III both UCC and DCC (n=17) using simple randomization technique . In milking group, Umbilical cord was milked 4 times towards the baby at a speed of 10 cm / sec . In Delayed Cord Clamping group cord was clamped and cut 2-3 cm distance from the umbilical stump after 3 minutes of birth. In Group III both procedures were done simultaneously. Statistical analysis: ANOVAwas used to compare mean difference of outcome between three intervention arms. Two tailed Pvalue of <0.05 was taken as significant. SPSS version 20.0 was used for data analysis Results: The baseline characteristics were mostly comparable in the all the groups. Maximum increase in Haemoglobin and PCV was seen in group II i.e delayed cord clamping . Mean haemoglobin and heamatocrit (PCV) levels at 72 hours of life neonates in group II (17.7g% and 55.4 ) and group III (17.3g% and 54) were comparable . Conclusion: Both the interventions i.e Delayed cord clamping performed alone or in combination with umbilical cord milking had comparable effect on hematological status in term neonates