Cord milking for the non-vigorous term baby, and a family history that changes postpartum VTE risk

The edition in brief

A Canadian technical update graded the evidence on intact umbilical cord milking for infants of 35 weeks or more who stay non-vigorous after brief deferred clamping and stimulation, concluding it may reduce moderate to severe hypoxic-ischaemic encephalopathy and the need for cardiorespiratory support, without a clear rise in jaundice needing phototherapy. A Swedish cohort of 856,380 first-time mothers found that a family history of venous thromboembolism carried a dose-graded risk of postpartum VTE, from HR 1.50 at the lowest hereditary score to 3.66 at the highest. A secondary analysis of the Dutch APRIL trial suggested that low-dose aspirin may help mainly where the placenta of the previous spontaneous preterm birth showed maternal vascular malperfusion, but the subgroup was 44 women. A meta-analysis of 23 trials of telemedicine in gestational diabetes reported modest glucose benefits with very high heterogeneity and low to very low certainty. The pearl covers taking a structured family VTE history at booking.