EJMS

Abstract

Objective: The study aims to compare the short term risks and benefits of delayed cord clamping in the full term neonate delivered by caesarean section compared to milking of the umbilical cord. Design: randomized controlled trial. Setting: Ain Shams Maternity teaching hospital. Patients and methods: a total of 300 pregnant women who are medically free and completed 37 weeks of gestational age (met the inclusion criteria) who attended the casualty of Ain Shams University Maternity Hospital for an elective caesarean section and completed the study. Intervention: The patients were divided into two groups: Group I: milking group which contains 150 patients, defined as application of a clamp to the umbilical cord after milking of the cord 5 times toward the neonate. Group II: Late (delayed) cord clamping which contains 150 patients, Then all the neonates will be subjected to Apgar score evaluation after 5 minutes, Hb level 6 weeks later, need for NICU and all mothers subjected to need for ICU admission, blood transfusion, need for extre-utero tonics and need for manual removal of the placenta. Results: On comparing the two groups regarding Hb level after 6 weeks; Group I the mean Hb level was 9.95 ± 0.88 mg/dl, and Group II was 9.86 ± 0.71 mg/dl with a p value 0.338 which is not significant. In group I, 12 neonates were admitted to NICU for jaundice which represents (8%) and Group II 16 neonates were admitted to NICU for jaundice which represents (10.7%) with a p value 0.427 which is not significant. Conclusion: Both UCM and DCC have comparable benefits in improving hematological status at 6 weeks without affecting producing any noteworthy significant adverse neonatal outcomes in initial 6weeks of life.