Comparing Delayed Cord Clamping and Umbilical Cord Milking During Elective Cesarean Section for the Neonatal Outcome

Study Overview
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Brief Summary
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the study is conducted on the different actions on umbilical cord clamping including immediate cord clamping (ICC) , delayed cord clamping (DCC) for 30 seconds and umbilical cord milking (UCM) for 10-15 seconds in females that are delivered by elective cesarean section , to assess the neonatal outcomes including Hemoglobin and Hematocrit levels after birth in the newborn and the bilirubin level after 72 hrs

Detailed Description
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the benefit of umbilical cord milking for 10-15 seconds maneuver in cesarean section, that short time can improve the hemoglobin level and prevent anemia in the newborn with improvement of the iron stores for months in infancy without affection on the bilirubin level and the need for phototherapy. This is significant because of the rising rate of cesarean section all over the world make more children are liable for anemia, and by this simple technique it can be prevented.

Official Title
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Comparing Delayed Cord Clamping and Umbilical Cord Milking During Elective Cesarean Section for the Neonatal Outcome

Conditions
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Umbilical Cord Milking

Intervention / Treatment
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* Procedure: Delayed cord clamping for 30 seconds


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: mother's age (20-40) years. pregnancy with a healthy singleton gestational age of 38-41 0/7 weeks uncomplicated pregnancy Exclusion Criteria Any medical or obstetrical complications like hypertension, pre-eclampsia, diabetes any special habits like smoking, and substance abuse Rh-negative mothers. The fetal exclusion criteria fetus with evidence of intrauterine growth restriction infant with serious congenital anomalies.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Immediate cord clamping<br>this arm where the patient didn't receive any special maneuver and immediate cord clamping after delivery of the fetus is done | |
| Experimental: Delayed cord clamping<br>this arm where the patient receive a delay in cord clamping for 30 seconds after delivery of the fetus | Procedure: Delayed cord clamping for 30 seconds<br>* waiting for 30 seconds after delivery of the fetus or milking of the cord in the direction of the fetus 10 times in time frame 10-15 seconds<br>* Other names: Umbilical cord milking;|
| Experimental: Umbilical cord milking<br>this arm where the patient receive stripping of the umbilical cord in the direction of the fetus 10 times in a time frame 10-15 seconds after delivery of the fetus | Procedure: Delayed cord clamping for 30 seconds<br>* waiting for 30 seconds after delivery of the fetus or milking of the cord in the direction of the fetus 10 times in time frame 10-15 seconds<br>* Other names: Umbilical cord milking;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hemoglobin level | a blood sample is taken from the umbilical cord of the neonate | immediately after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| bilirubin level | trans-cutaneous measurement of the bilirubin level | 72 hours after delivery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cesarean section, umbilical cord milking, hemoglobin