Effect of Milking Maneuver in Preterm Infants: A Randomized Controlled Trial

• Published in: Fetal diagnosis and therapy Vol. 45; no. 1; p. 57
• Main Authors: Lago Leal, Víctor, Pamplona Bueno, Loida, Cabanillas Vilaplana, Lucía, Nicolás Montero, Estefanía, Martín Blanco, Mónica, Fernández Romero, Cristina, El Bakkali, Sara, Pradillo Aramendi, Tamara, Sobrino Lorenzano, Lara, Castellano Esparza, Paula, Ballesteros Benito, Esther, Rayo Navarro, Nieves, Del Barrio Fernández, Pablo, Ocaña Martínez, Vanesa, Martínez Cortés, Luis
• Format: Journal Article
• Language: English
• Published: Switzerland 2019
• Subjects: Delayed cord clamping; Preterm delivery; Early cord clamping; Blood transfusion; Randomized controlled trial; Umbilical cord milking; Phototherapy
• ISSN: 1421-9964
• DOI: 10.1159/000485654

To assess the short and medium-term effects of milking maneuver (MM) compared with early cord clamping for infants born before 37 weeks of pregnancy. 138 infants between 24+0 and 36+6 weeks of gestation were allocated to MM or early cord clamping. Primary outcomes were the requirement of red blood cell transfusions or phototherapy. Initial hemoglobin was significantly higher in the MM group by 1.675 g/dL (p < 0.05) and initial hematocrit by 5.36% (p < 0.05), but no differences in the need of transfusion during the first 30 days after delivery were found (RR 0.8; 95% CI 0.22-2.85). Peak serum bilirubin was similar in both groups (11,097 ± 3.21 vs. 11,247 ± 3.56 mg/dL, p = 0.837). Phototherapy requirements were higher in the MM group (RR 1.62; 95% CI 1.1-2.38). No differences regarding the need of oral iron supplementation, platelet transfusion, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, necrotizing enterocolitis, periventricular leukomalacia, meconium aspiration syndrome, use of surfactant, days of oxygen supplementation, need of vasopressors, length of stay in the neonatal intensive care unit, or postpartum hemorrhage were found. MM does not reduce the need for red blood cell transfusions and increases phototherapy requirements in preterm infants.