Comparison of Intact Cord Milking and Cut Cord Milking Among Neonates ≥28 Weeks Requiring Resuscitation at Birth: Protocol of a Randomized Controlled Trial

Abstract Background Delayed cord clamping (DCC) and umbilical cord milking (UCM) may improve placental transfusion and neonatal hematological outcomes. In neonates requiring resuscitation at birth, intact cord milking (I-UCM) and cut cord milking (C-UCM) may provide alternative approaches to facilitate placental transfusion. Evidence comparing these approaches in neonates requiring resuscitation is limited. Methods This is a single-centre, prospective, two-arm, parallel-group, superiority randomized controlled trial conducted at St John’s Medical College and Hospital, Bengaluru, India. Neonates born at ≥ 28 weeks of gestation who require resuscitation at birth are eligible. Mothers are approached antenatally and written informed consent is obtained before delivery. Eligible participants are randomized in a 1:1 ratio before birth, with stratification by gestational age (< 37 weeks and ≥ 37 weeks). Trial Registration CTRI/2025/01/079614 prospectively registered on 28 January 2025.