Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: The Effect of Umbilical Cord Milking on Hemodynamic Status of Preterm Infants: a Randomized Controlled Trial
Brief Summary: Very preterm babies frequently develop problems with their blood circulation during the first few days after birth. These circulation problems could affect the oxygen and blood flow to their brain and lead to effects such as bleeding in the head or delayed developmental milestones later in life. Currently the care for such problems may include transfusion of intravenous fluids or blood to the baby and/or giving the baby medications that can help circulation.

The current practice at the delivery of these babies is to immediately clamp their umbilical cords after birth. Recent research studies have shown that giving more of the baby's own blood to them at birth by delayed cord clamping (waiting for clamping the cord for about 30-90 seconds) or by milking the cord, may reduce the number of blood transfusions that these babies may need later on. It may also improve their initial blood pressure and reduce the chances of bleeding in their heads.

More research is needed to prove if either delayed cord clamping or milking the cord at birth will be better in terms of improving these babies' health.

The aim of this study is to find out if adding some blood to these babies' circulation, through milking the cord at birth, could prevent or reduce the possible problems with blood circulation and the reduced blood flow to the brain that some of these babies may have after birth.

The investigators will also investigate if milking the cord at birth could improve their long-term developmental outcome.

Hypothesis: In preterm infants less than 31 weeks' gestation, milking the umbilical cord 3 times prior to clamping, compared to immediate clamping after birth will improve systemic blood flow (as assessed by improving superior vena cava flow measured by heart ultrasound in the first 24 hours after birth)


Options:
A: Arm Label: A; Type: EXPERIMENTAL; Interventions: Procedure: Delayed Cord Clamping | Arm Label: B; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Immediate Cord Clamping | Intervention Type: PROCEDURE; Name: Delayed Cord Clamping; Assigned to Arm(s): A | Intervention Type: PROCEDURE; Name: Immediate Cord Clamping; Assigned to Arm(s): B
B: Arm Label: Early umbilical cord clamping (control); Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Delayed umbilical cord clamping; Type: EXPERIMENTAL; Interventions: Procedure: Delayed umbilical cord clamping | Intervention Type: PROCEDURE; Name: Delayed umbilical cord clamping; Assigned to Arm(s): Delayed umbilical cord clamping
C: Arm Label: 1-Delayed Cord Clamping (DCC); Type: EXPERIMENTAL; Interventions: Procedure: delayed umbilical cord clamping | Arm Label: 2-Immediate Cord Clamping (ICC); Type: ACTIVE_COMPARATOR; Interventions: Other: Immediate cord clamping | Intervention Type: PROCEDURE; Name: delayed umbilical cord clamping; Assigned to Arm(s): 1-Delayed Cord Clamping (DCC) | Intervention Type: OTHER; Name: Immediate cord clamping; Assigned to Arm(s): 2-Immediate Cord Clamping (ICC)
D: Arm Label: immediate umbilical cord clamping; Type: ACTIVE_COMPARATOR; Interventions: Procedure: immediate umbilical cord clamping | Arm Label: Milking the umbilical cord at birth; Type: EXPERIMENTAL; Interventions: Procedure: Milking the umbilical cord at birth | Intervention Type: PROCEDURE; Name: Milking the umbilical cord at birth; Assigned to Arm(s): Milking the umbilical cord at birth | Intervention Type: PROCEDURE; Name: immediate umbilical cord clamping; Assigned to Arm(s): immediate umbilical cord clamping

Answer: D