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Review
. 2023 Apr 18:11:1146057.
doi: 10.3389/fped.2023.1146057. eCollection 2023.

Umbilical cord milking-benefits and risks

Jenny Koo  1 , Hasan Kilicdag  2 , Anup Katheria  1
Affiliations
Review

Umbilical cord milking-benefits and risks

Jenny Koo et al. Front Pediatr. .

Abstract

The most common methods for providing additional placental blood to a newborn are delayed cord clamping (DCC) and umbilical cord milking (UCM). However, DCC carries the potential risk of hypothermia due to extended exposure to the cold environment in the operating room or delivery room, as well as a delay in performing resuscitation. As an alternative, umbilical cord milking (UCM) and delayed cord clamping with resuscitation (DCC-R) have been studied, as they allow for immediate resuscitation after birth. Given the relative ease of performing UCM compared to DCC-R, UCM is being strongly considered as a practical option in non-vigorous term and near-term neonates, as well as preterm neonates requiring immediate respiratory support. However, the safety profile of UCM, particularly in premature newborns, remains a concern. This review will highlight the currently known benefits and risks of umbilical cord milking and explore ongoing studies.

Keywords: delayed cord clamping; infants; newborn; placental transfusion; umbilical cord milking.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Early cord clamping (ECC) vs delayed cord clamping (DCC) vs. intact cord umbilical cord milking (I-UCM) vs. cut-cord umbilical cord milking (C-UCM). Different methods of cord management are depicted here.
Figure 2
Figure 2
Cardiorespiratory changes during respiration before cord clamping. Respiration and lung recruitment drops the pulmonary vascular resistance (PVR), collapses the inferior vena cava (IVC), and thereby increases the flow of blood from the ductus venosus (DV). This increases cardiac output (CO) which in turn stabilizes the heart rate (HR), blood pressure (BP), and reduce the risk of intraventricular hemorrhage (IVH).
Figure 3
Figure 3
Umbilical cord milking (UCM) increases CD34 + pluripotent stem cells in babies, which have potential benefits as summarized in the figure. IVH, intraventricular hemorrhage; PVL, periventricular leukomalacia; HIE, hypoxic ischemic encephalopathy. ROP, retinopathy of prematurity; BPD, bronchopulmonary dysplasia; CDH, congenital diaphragmatic hernia; PH, pulmonary hypertension; NEC, necrotizing enterocolitis.
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References

    1. Ritchie H, Mathieu E. 12/27/2022]; Available at: https://ourworldindata.org/births-and-deaths
    1. Linderkamp O. Placental transfusion: determinants and effects. Clin Perinatol. (1982) 9(3):559–92. 10.1016/S0095-5108(18)31013-3 - DOI - PubMed
    1. Kiserud T. Physiology of the fetal circulation. Semin Fetal Neonatal Med. (2005) 10(6):493–503. 10.1016/j.siny.2005.08.007 - DOI - PubMed
    1. Erickson-Owens DA, Mercer JS, Oh W. Umbilical cord milking in term infants delivered by cesarean section: a randomized controlled trial. J Perinatol. (2012) 32(8):580–4. 10.1038/jp.2011.159 - DOI - PubMed
    1. Mercer JS, Skovgaard RL. Neonatal transitional physiology: a new paradigm. J Perinat Neonatal Nurs. (2002) 15(4):56–75. 10.1097/00005237-200203000-00007 - DOI - PubMed
-