ปริมาตรเม็ดเลือดแดงในเลือดและระดับไมโครบิลิรูบินที่ 48 ชั่วโมง ภายหลังการผ่าท้องทำคลอดของทารกครรภ์ครบกำหนด เปรียบเทียบระหว่างการหนีบสายสะดือช้าที่ 60 วินาที กับการหนีบสายสะดือช้าที่ 60 วินาทีร่วมกับการรีดเลือดตัดสายสะดือ

Wichan Kaewkhiew

Authors

Wichan Kaewkhiew Department of Obstetrics and Gynecology, Sansai Hospital

Keywords:

Umbilical cord milking, Delayed cord clamping, Cesarean delivery

Abstract

Background: Management of neonatal anemia often involves delayed umbilical cord clamping (DCC) or umbilical cord milking (UCM). Evidence regarding the combined effect of DCC and UCM in cesarean-delivered neonates remains scarce. Objective: To compare hematocrit (Hct) and microbilirubin levels at 48 hours of age in full-term infants delivered by cesarean section between those receiving DCC for 60 seconds and those undergoing DCC for 60 seconds plus UCM. Methods: A retrospective cohort study was performed using data from the HosOS39 program between May 1st, 2023, and January 31st, 2024. Infants in the control group received DCC for 60 seconds, while the intervention group received DCC for 60 seconds followed by UCM of a 25 cm cord segment. Hct and microbilirubin values at 48 hours were compared using student’s t-test and Fisher’s exact test. Results: A total of 160 neonates were included: 83 in the control group and 77 in the intervention group. Maternal and neonatal baseline characteristics were similar between groups. The intervention group showed significantly higher mean Hct levels than the control group (53.9 ± 5.6% vs. 52.0 ± 5.1%, p = .024). Microbilirubin levels did not differ significantly (9.4 ± 2.3 mg/dL vs. 9.1 ± 2.0 mg/dL, p = .314). Conclusion: DCC for 60 seconds combined with cut UCM significantly increased neonatal hematocrit without elevating microbilirubin levels or causing complications. However, as baseline cord blood Hct was not obtained, the causal relationship cannot be fully established. Prospective studies measuring Hct both before and after the intervention are warranted.

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