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Cord milking/delayed clamping at the 2015 PAS-meeting



I have tried to go through the abstracts from PAS to find those that had new information, from controlled trials, about the efficacy and safety of cord milking and/or delayed clamping.

Mercer and the group from Rhode Island presented the 18-22 month follow-up of about 200 very preterm (<32 wks) babies randomized to immediate compared to delayed (30 to 45 s, combined with one milking of the cord) clamping. There was no effect on IVH in the groups they compared here, but there were fewer babies with Bayley motor scores under 85.

Hosono was the first author of the paper about cord milking from a few years ago. This time he led a multi-center RCT which compared cord milking in a new way that they described in another of the articles I just briefly reviewed, that is cutting the cord very long, then a one time milking of the cord. There were 100 patients in each group when they stopped the study, but they only present data in the abstract from 77 per group. Don't know why. They say that there were fewer severe IVH (no data but they write p<0.04) and less mortality in the one time cord milking group.

The APTS study echocardiographic sub-study (Popat et al) reported cardiac function findings after delayed cord clamping (at least 60 seconds) compared with immediate clamping in about 260 babies of less than 30 weeks gestation. They found very little difference in cardiac function, BP was unaffected, SVC flow was the same, and right ventricular output was a little lower.

Anup Katheria from San Diego led a 2 center trial looking at hemodynamics after cord milking in very preterm babies delivered by C-Section. They showed higher BP and higher RVO in the cord milking group.

Most of the other abstracts were either before/after reports, or concentrated on hemoglobin, as far as I can see.


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