When it comes to improving systemic blood flow in preterm infants, recent recommendations (doi: 10.1542/peds.2013-0191) point to delayed cord clamping as a preferred method of placental transfusion. Yet other studies suggest that if a preterm infant is delivered by caesarean section rather than vaginal delivery, the amount of blood transfused via delayed cord clamping is less than desired, prompting a resurgence of interest in umbilical cord milking.
Anup et al. (doi:10.1542/peds.2015-0368) report this week on a two-center trial to see if preterm infants randomized to get one technique or the other show better systemic blood flow with one of these two methods used for both vaginal and caesarean section deliveries. While no differences were noted regardless of method used for vaginal deliveries, umbilical cord milking appears to be statistically better for improving systemic blood flow in the setting of a caesarean section. So is this study enough to change current recommendations for delayed cord clamping?
You will want to also read the commentary by Drs. Tarnow-Mordi and Soll (doi: 10.1542/peds.2015-1545) that accompanies this study to determine whether this study resolves the best method for placental transfusion or not. Which method do you prefer and why? Will this study convince your local obstetrician to milk the cord rather than delay in clamping it?
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