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| ID | Type | Description | Link |
|---|---|---|---|
| R03HD072934-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | NIH |
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Premature babies can be very sick and have bleeding in the brain. Giving babies more blood before cutting the umbilical cord by delayed cord clamping or umbilical cord milking has been shown to reduce the risk of bleeding in the brain. This may be related to improving perfusion to the brain. However, some studies suggest that delayed cord clamping may not increase hemoglobin or blood volume in babies delivered by cesarean section. Milking the umbilical cord may give more blood in babies delivered by Cesarean Section may improve perfusion and reduce bleeding in the brain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Umbilical Cord Milking | Active Comparator | Milking the umbilical cord 4 times towards the infants at a speed of 20cm/2 seconds |
|
| Delayed Cord Clamping | Active Comparator | Delayed clamping of the umbilical cord for 45-60 seconds |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Umbilical Cord Milking | Procedure | Umbilical cord milked toward the neonate four times at a speed of 20cm/2seconds, prior to clamping and cutting umbilical cord. Procedure takes about 10-20 seconds. |
| Measure | Description | Time Frame |
|---|---|---|
| Superior Vena Cava Flow | <12 hours of life |
| Measure | Description | Time Frame |
|---|---|---|
| Delivery Room Interventions | 10 minutes of life | |
| Hemoglobin | <1 hour | |
| Hemoglobin |
| Measure | Description | Time Frame |
|---|---|---|
| Days on Oxygen | during hospitalization | |
| Vaginal Delivered infants (no difference in interventions) | up to 24 weeks after birth | |
| Cerebral Tissue Oxygenation |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anup C Katheria, MD | Sharp HealthCare | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Loma Linda Medical Center | Loma Linda | California | 92350 | United States | ||
| Sharp Mary Birch |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26122803 | Background | Katheria AC, Truong G, Cousins L, Oshiro B, Finer NN. Umbilical Cord Milking Versus Delayed Cord Clamping in Preterm Infants. Pediatrics. 2015 Jul;136(1):61-9. doi: 10.1542/peds.2015-0368. | |
| 29246467 | Background | Katheria A, Garey D, Truong G, Akshoomoff N, Steen J, Maldonado M, Poeltler D, Harbert MJ, Vaucher YE, Finer N. A Randomized Clinical Trial of Umbilical Cord Milking vs Delayed Cord Clamping in Preterm Infants: Neurodevelopmental Outcomes at 22-26 Months of Corrected Age. J Pediatr. 2018 Mar;194:76-80. doi: 10.1016/j.jpeds.2017.10.037. Epub 2017 Dec 12. |
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| Delayed Cord Clamping | Procedure | Performed by positioning the baby 20 cm below the placenta for 45-60 seconds prior to umbilical cord clamping and cutting. |
|
| 12 hours |
| Hemoglobin | 4 weeks of life |
| Neurodevelopmental impairment 18-36 months | 18-36 months |
| Severe intraventricular hemorrhage (grade 3 or 4) | up to 24 weeks after birth |
| Phototherapy | Requirement and length of phototherapy | up to 24 weeks after birth |
| Ionotropic support | Requirement and length of ionotropic support | up to 24 weeks after birth |
| Neonatal intensive care unit (NICU) length of stay | up to 24 weeks after birth |
| Necrotizing enterocolitis | up to 24 weeks after birth |
| Number of blood transfusions while in the neonatal intensive care unit | up to 24 weeks after birth |
| Ventilator time | up to 24 weeks after birth |
| Apgar score <7 at 5 minutes | at 5 minutes after birth |
| Umbilical cord pH < 7.0 | up to 30 minutes after birth |
| Blood pressure in first 2 hours of admission to neonatal intensive care unit | 2 hours after birth |
| Polycythemia | up to 24 hours of life |
| Neonatal death | up to 24 weeks of life |
| Use of uterotonic agents | up to 1 hour after birth |
| Peak transcutaneous and/or serum bilirubin concentrations | up to 24 weeks after birt |
| Maternal hemoglobin | within 48 hours after delivery |
| Intraventricular Hemorrhage detected on Head Ultrasound | up to 24 weeks after birth |
| Up to 24 hours of life |
| Cardiac output by electric cardiometry | up to 24 hours of life |
| Stroke volume by electric cardiometry | Up to 24 hours of life |
| San Diego |
| California |
| 92123 |
| United States |
| University of California, San Diego | San Diego | California | 92130 | United States |
| ID | Term |
|---|---|
| D000087526 | Umbilical Cord Clamping |
| ID | Term |
|---|---|
| D036861 | Delivery, Obstetric |
| D013513 | Obstetric Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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