title: Comparison of Umbilical Cord Milking and Delayed Cord Clamping on Cerebral Blood Flow in Term Neonates.
abstract: OBJECTIVE
  To compare the effect of umbilical cord milking (UCM) and delayed cord clamping (DCC) on cerebral blood flow in term neonates.
  
  
  METHODS
  This randomized controlled trial was conducted at a teaching hospital in India during 2012 to 2013. Two hundred newborns (>36wk) were randomized to UCM and DCC groups. UCM was done on 25cm of cord length. In DCC group, clamping was delayed by 60 to 90s. Resistive Index (RI), Pulsatility Index (PI) and cerebral blood flow velocities of middle cerebral artery (MCA) were measured at 24 to 48h of life.
  
  
  RESULTS
  Baseline characteristics and hemodynamic parameters were comparable. Mean PI [1.18 (0.26)] and RI [0.65 (0.08)] in UCM group was comparable to mean PI [1.18 (0.25)] and RI [0.65 (0.08)] in DCC group. The peak systolic velocity and end diastolic velocity (cm/s) of blood flow in MCA for UCM group were 34.94 (11.82) and 11.71 (4.75) respectively, while in DCC group they were 37.24 (12.63) and 13.07 (4.78) (p 0.23 and 0.07) respectively. Indices among growth retarded babies were not different.
  
  
  CONCLUSIONS
  DCC and UCM had similar effect on cerebral blood flow velocities and Doppler indices in MCA, in term neonates.
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut, Uttar Pradesh, 250004, India.
authors.forename: Prateek
authors.initials: P
authors.lastname: Jaiswal
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut, Uttar Pradesh, 250004, India. au.llrm@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Upadhyay
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut, Uttar Pradesh, 250004, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Gothwal
authors.affiliation: Department of Radiodiagnosis, LLRM Medical College, Meerut, Uttar Pradesh, India.
authors.forename: Hema
authors.initials: H
authors.lastname: Chaudhary
authors.affiliation: Department of Radiodiagnosis, LLRM Medical College, Meerut, Uttar Pradesh, India.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tandon
mesh_terms: D002560:Cerebrovascular Circulation / Q000502:physiology*; D003250:Constriction; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D007231:Infant, Newborn; D008297:Male; D011673:Pulsatile Flow; D013997:Time Factors; D017585:Ultrasonography, Doppler, Transcranial; D014470:Umbilical Cord / Q000098:blood supply* / Q000601:surgery
keywords: Cerebral blood flow; Pulsatility index; Resistance index; Term neonates