Stefan Johansson 631 Posted November 8, 2017 Share Posted November 8, 2017 I guess many of you have seen that the Australian placental transfusion study is now published in NEJM. In this RCT - 1500 infants born <32 weeks were randomized to early vs late clamping (≤10 vs ≥60 sec). The results were... no clear benefits, the odds ratio was 1.00 (0.88.-1.13) for the combined primary outcome of death or major morbidity. We have not yet discussed in our NICU how to relate to those findings - we currently practise delayed clamping (at 60 sec). Thoughts? 1 Link to post Share on other sites
Francesco Cardona 129 Posted November 10, 2017 Share Posted November 10, 2017 The wrath of combined outcomes! 1 Link to post Share on other sites
chienyichen 10 Posted November 13, 2017 Share Posted November 13, 2017 I am wondering if any one have experience about milking. Our Obs doctors seemed like to do it more..... Link to post Share on other sites
Stefan Johansson 631 Posted November 13, 2017 Author Share Posted November 13, 2017 @chienyichen maybe they have read a paper from 2015, a relatively small trial reviewed by @EBNEO , read the link below. I personally think that paper only shows a proxy outcome and that a larger trial with meaningful clinical outcomes (like RDS, BPD, IVH etc-etc) should show benefits before changing practise. (but we do delayed clamping though ) https://ebneo.org/2015/12/does-umbilical-cord-milking-result-in-higher-measures-of-systemic-blood-flow-in-preterm-infants/ Link to post Share on other sites
tarek 84 Posted November 13, 2017 Share Posted November 13, 2017 WHO recommendation with delayed cord clamping even for 3 minutes NRP guidlines latest edition with delayed cord clamping from 30 -60 seconds In preterms: Decrease incidence of IVH Decrease incidence of NEC Reduce need for transfusion Avoid hypovolemic hypotension For full term Studies showed that improve iron stores in first few months The American college of obstetrician and gynacologists recommend delayed cord clamping in there commite meeting in 2016 Link to post Share on other sites
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