Ghulam Sabir, Ayesha Raja, Saira Mahboob, Saima Shoukat, Ali Kashif, Shazia Iffat.
Comparison of delayed cord clamping and cord milking effects on neonatal APGAR score and haematocrit.
Pak Armed Forces Med J Jan ;71(5):1811-15.

Objective: To assess the feasibility of umbilical cord milking as an alternative to delayed cord clamping during caserean section by comparing neonatal outcomes. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital, Okara, from Mar to Oct 2018. Methodology: A total of 384 cases (n=192 in each group) were included in our study. In group A, the half-length of umbilical cord was milked thrice by the operating surgeon before clamping and cutting it. In group B the umbilical cord was cut 90 second after delivery of the baby. The outcomes were: APGAR score at one and five minutes after delivery, haemglobin and haematocrit 4 hours after delivery of baby. Requirement of oxygen and ventilatory support during the 24 hours after birth were also noted. Results: Our two study groups didn’t vary in their demographic profile. The difference between the APGAR score at one and five minutes was not statistically significant, (p>0.05). The difference in haemoglobin and haematocrit levels of the neonates 4 hours after delivery were insignificant (p-value 0.27 and 0.14 respectively). Conclusion: Milking of the umbilical cord can be used as an alternative to the recommended technique of delayed umbilical cord clamping, especially when immediate resuscitation of the newborn is needed.

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