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Abstract During the transition to extra-uterine life, the respiratory function moves from the placenta to the lungs, the fetal shunts are closed, the lungs expand, and the placental circulation is removed. These major changes occur within minutes of initiating pulmonary ventilation and clamping the umbilical cord. There are three different techniques for moving placental blood to the neonate immediately after birth. Low birth weight infants can benefit from these techniques as they increase their blood volume at birth (10-15 mL/kg), which improves systemic blood flow, as measured by superior vena cava (SVC) flow and right ventricular output (RVO). For all preterm newborns, delay cord clamping (DCC) for at least 30-60 seconds should be the standard of care. Depressed neonates can benefit from umbilical cord milking as an alternative to DCC, which would facilitate the process and thus better hemodynamic transition. Our study was designed to perform echocardiography to assess the hemodynamic changes associated with different methods of placental transfusion (intact umbilical cord milking, cut- umbilical cord milking, and delayed cord clamping) used in premature neonates. A prospective randomized controlled clinical trial involved (57) preterm infants who met the eligibility criteria and were born at Alexandria University Maternity Hospital (AUMH) and admitted to NICU on the first day of life, and whose gestational age was 32 weeks or less, regardless of their birth weight. |