Effect Of Umbilical Cord Milking In Preterm Infants Delivered By Cesarean Section:A Randomized Controlled Trial

Objective:This research is to discuss the effect of umbilical cord milking on premature infants delivered by cesarean section at 28 to 34 weeks of gestational age,by comparing the related index of anemia,jaundice and incidence of complications of premature infants.To provide theoretical basis for the clinical application of umbilical cord milking.Method:100 premature infants of 28 to 34 weeks of gestational age delivered by cesarean section in the second Hospital of Jilin University from January 2018 to December 2018 were collected.The patients were divided into two groups:(UCM)group(n = 50)and(ICC)group(n = 50).All pregnant women in both groups were excluded from multiple pregnancy,placental abruption,placenta previa,and no history of severe anemia,liver and kidney diseases and immune diseases.No abnormal umbilical cord and placenta were found to affect fetal blood supply,both groups were excluded from RH negative and O blood.There were no severe asphyxia,no atresia of digestive tract,and no congenital malformations and diseases affecting metabolism in preterm infants.The premature infants were placed at the uterine level after delivery.Within 30 s after birth,the premature infants in the UCM group were clamped at the 25 cm at the root of the umbilical cord and pressed the umbilical cord 2 times at the speed of 10cm/s from the placenta direction to the newborn.Then the umbilical cord was cut off at the 2~3cm from the root of the umbilical cord.In the ICC group,the umbilical cord was cut off immediately after birth.Measurement and observation: 1)anemia related indexes: red blood cell count,hemoglobin content,(Hb),hematocrit(Hct),during hospitalization and incidence of blood transfusion at the beginning of birth and 1 week;2)jaundice related indexes: peak value of transcutaneous bilirubin,blue light therapy rate and treatment time,pathological jaundice rate,polycythemia rate;3)vital signs related indicators: mean blood pressure at birth,24 hours(MBP),heart rate(HR);4)other complications during hospitalization: neonatal respiratory distress syndrome(RDS),)intracerebroventricular hemorrhage(IVH),myocardial injury,necrotizing enterocolitis(NEC),bronchopulmonary dysplasia(BPD),white matter injury(WMI),Incidence of(ROP)in retinopathy.Results:UCM could significantly increase the count of red blood cell and the value of Hb?Hct,decrease the rate of anemia and blood transfusion,and not increase the peak value of serum bilirubin,the incidence of pathological jaundice and polycythemia in premature infants of 28-34 weeks of gestational age.There was no significant effect on the rate and duration of blue light therapy.It can increase average blood pressure,improve tissue perfusion and reduce the incidence of IVH in premature infants.