Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2026
Technical Update No. 472: The Resuscitative Use of Intact Umbilical Cord Milking for Non-Vigorous Late Preterm (≥350 weeks of gestation) and Term Infants.
СтатьяКлинические рекомендацииНазвание и аннотация: Перевод пока не подготовлен
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Cook Jocelynn, McDonald Sarah D, Mitra Souvik, Jain Venu
Аннотация
OBJECTIVE: To assess the benefits and risks of intact umbilical cord milking in non-vigorous infants from 35 weeks onwards.
TARGET POPULATION: Non-vigorous infants at a gestational age of ≥350 weeks.
OPTIONS: To administer or withhold intact umbilical cord milking in non-vigorous infants at a gestational age of ≥350 weeks.
OUTCOMES: The primary outcomes assessed included neonatal mortality and morbidity, including hypoxic-ischemic encephalopathy, the need for resuscitation, and cardiorespiratory support.
BENEFITS, HARMS, AND COSTS: In term and late preterm infants who remain non-vigorous despite stimulation, intact umbilical cord milking may reduce the incidence of moderate to severe hypoxic ischemic encephalopathy and the need for cardiorespiratory support. Available evidence does not suggest a significant increase in neonatal adverse outcomes, including jaundice requiring phototherapy.
EVIDENCE: Medline, PubMed, EMBASE, and the Cochrane Library were searched from April 1, 2020 to May 27, 2026 for medical subject heading (MeSH) terms and keywords related to deferred/delayed cord clamping and umbilical cord milking, and neonatal morbidity and mortality. Other relevant guidelines were also included. This document represents an abstraction of the evidence rather than a methodological review.
VALIDATION METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix A (Tables A1 for definitions and A2 for interpretations).
INTENDED AUDIENCE: Obstetric care providers, including obstetricians, family physicians, nurses, midwives and maternal-fetal medicine specialists.
SOCIAL MEDIA ABSTRACT: If an infant at a gestational age of ≥350 weeks, after 15 seconds of deferred (delayed) cord clamping and tactile stimulation while being kept warm still remains non-vigorous, then intact umbilical cord milking (UCM) may be considered to decrease hypoxic ischemic encephalopathy (HIE) and the need for cardiorespiratory support.
TARGET POPULATION: Non-vigorous infants at a gestational age of ≥350 weeks.
OPTIONS: To administer or withhold intact umbilical cord milking in non-vigorous infants at a gestational age of ≥350 weeks.
OUTCOMES: The primary outcomes assessed included neonatal mortality and morbidity, including hypoxic-ischemic encephalopathy, the need for resuscitation, and cardiorespiratory support.
BENEFITS, HARMS, AND COSTS: In term and late preterm infants who remain non-vigorous despite stimulation, intact umbilical cord milking may reduce the incidence of moderate to severe hypoxic ischemic encephalopathy and the need for cardiorespiratory support. Available evidence does not suggest a significant increase in neonatal adverse outcomes, including jaundice requiring phototherapy.
EVIDENCE: Medline, PubMed, EMBASE, and the Cochrane Library were searched from April 1, 2020 to May 27, 2026 for medical subject heading (MeSH) terms and keywords related to deferred/delayed cord clamping and umbilical cord milking, and neonatal morbidity and mortality. Other relevant guidelines were also included. This document represents an abstraction of the evidence rather than a methodological review.
VALIDATION METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix A (Tables A1 for definitions and A2 for interpretations).
INTENDED AUDIENCE: Obstetric care providers, including obstetricians, family physicians, nurses, midwives and maternal-fetal medicine specialists.
SOCIAL MEDIA ABSTRACT: If an infant at a gestational age of ≥350 weeks, after 15 seconds of deferred (delayed) cord clamping and tactile stimulation while being kept warm still remains non-vigorous, then intact umbilical cord milking (UCM) may be considered to decrease hypoxic ischemic encephalopathy (HIE) and the need for cardiorespiratory support.