Evaluating Otherwise-Discarded Umbilical Cord Blood as a Source for a Neonate’s Complete Blood Cell Count at Various Time Points

Abstract

Background: Previous studies have reported the use of cord blood for admission laboratory complete blood counts (CBCs). However, no studies have investigated its stability for the first 30 min after delivery. Objectives: We quantified blood cells drawn from the umbilical vein to determine the effect of (1) the time after placental delivery, and (2) the site of blood sampling (umbilical vein on an isolated cord segment vs. umbilical vein on the placental surface). Methods: Timed phlebotomies were drawn at 2, 10, and 30 min from (1) the umbilical vein on an isolated, double-clamped cord segment, and (2) the umbilical vein near or on the placental surface. Leukocyte count, hemoglobin, platelet count, and fibrinogen were measured on each phlebotomy sample. Results: Blood drawn from the isolated umbilical cord segments had leukocyte count, hemoglobin, platelet count, and fibrinogen that remained unchanged between the phlebotomies at 2, 10, and 30 min after delivery. However, blood drawn from the umbilical vein on the placental surface had, at 30 min, a leukocyte count (p = 0.002), hemoglobin (p = 0.01), and platelet count (p = 0.001) that were statistically different from the values at 2 and 10 min after delivery. There was no difference in fibrinogen at 2, 10, or 30 min. Conclusions: If cord blood is used for a neonate’s initial CBC, the blood should be drawn within 10 min of the placental delivery when it is taken from the umbilical vein on or near the placenta. If an umbilical cord segment is obtained, the phlebotomy can be delayed for up to 30 min.

Banked term umbilical cord blood to meet the packed red blood cell transfusion needs of extremely-low-gestational-age neonates: a feasibility analysis

“…In recent decades, implementing RBC Tx-reduction strategies has diminished NICU RBC TX rates [38][39][40][41]. These strategies have included, 1) instituting transfusion guidelines [31,38,39,42], 2) reducing number and volume of blood draws form neonates for laboratory testing [43], 3) delayed umbilical cord clamping [44], 4) umbilical cord milking (if delayed clamping is not possible) [45], 5) drawing initial blood for laboratory tests not from the neonate but from otherwise discarded umbilical cord blood [40,46], 6) selectively administering erythropoietic stimulating agents [47], and 7) assuring iron su ciency [48].…”

Cord Platelet Count of Full-Term Neonates in Relation to ABO Incompatibility and Glucose-6-Phosphate Dehydrogenase Levels: A Retrospective Cohort Study

“…First, we had no data on the timing of umbilical cord sampling. It has been shown that the platelet count was slightly higher if the blood sampling was performed after 10 minutes of placental delivery from the umbilical vein near or on the placental surface or after 30 minutes from an umbilical cord segment [ 47 ]. Second, although our total sample size was large, it was not large enough in certain strata.…”

Reference intervals for complete blood count from Umbilical Cord Blood in newborns and comparison with Venous Blood Values

“…In the studies in which umbilical cord and venous blood samples taken simultaneously from newborns, a significant difference was reported between these two samples in terms of CBC results. 6,[11][12][13] In a study conducted with 174 newborns, it was found that leukocyte, neutrophil and lymphocyte counts were significantly higher in umbilical cord blood. 6 However, the authors found the groups similar in terms of mean monocyte, eosinophil and platelet counts.…”