The objective of this study is to evaluate the general course and prognosis associated with different methods of placental transfusion (Intact umbilical cord milking, cut- umbilical cord milking and delayed cord clamping) in premature neonates over the first days of life
Premature neonates ≤ 32 weeks gestational age regardless birth weight
patients should be admitted to neonatal intensive care unit in the first day of life of life
Major congenital anomalies (complex cyanotic heart disease, major central nervous system anomalies).
Evidence of head trauma causing major intracranial hemorrhage.
placental abnormalities like : abruptions, placenta previa or retroplacental hematoma.
Cord accident, or avulsion at the time of delivery.
Parallel
intact umbilical milking
Procedure/SurgeryUmbilical cord milking will be performed by holding the newborn at or ∼20 cm below the level of the placenta. The cord will be pinched between 2 fingers as close to the placenta as possible and milked toward the infant over a 2-second duration. The cord will then be released and allowed to refill with blood for a brief 1- to 2-second pause between each milking motion. This will be repeated for 2-4 times. After completion, the cord will be clamped, and the neonate will be handed to the resuscitation team.
cut umbilical milking
Procedure/SurgeryAnother technique, used more often in Asia, involves clamping and cutting a long segment of the umbilical cord immediately at birth and passing the baby and the long cord to the pediatric provider, called C-UCM untwists the cord and milks the entire contents into the baby. Milking the cord 2-3 times before clamping may produce a similar placental transfusion as C-UCM
Delayed cord clamping
Procedure/SurgeryInfants placed on the maternal abdomen or at the introitus below the level of placenta and waiting at least 30- to 60-second before clamping the cord.
Hemoglobin level
hemoglobin level will be measured in gram/dl
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