Placing the newborn on the maternal abdomen increases the volume of umbilical cord blood collected

Abstract

Haematopoietic stem cell transplantation is an important therapy for certain haematological and malignant disorders. Umbilical cord blood contains a high proportion of potentially transplantable haematopoietic progenitor cells. However, the use of cord blood stem cell transplantation is limited by the low number of stem cells obtainable from a single cord blood donor. The aim of our study was to investigate the possibility that procedures during delivery might influence the number of umbilical cord blood haematopoietic progenitor cells available for transplantation. We assessed the effects of upper and lower positions of the newborn infant on the yield of cord blood stem cells in 51 vaginal deliveries. Neonates in the upper position group were placed by the midwife on the maternal abdomen immediately after birth, while those in the lower position group were placed on the delivery table, below the maternal introitus. The total volume of cord blood and the total number of CD34+ cells collected from babies in the upper position group were significantly higher than those from babies in the lower position group. There were no significant differences in cord blood haemoglobin levels and white blood cell counts between the two groups, nor were there any adverse effects in the newborn infants. The simple manoeuvre of placing the newborn on the maternal abdomen after delivery may thus increase the yield of transplantable haematopoietic progenitor cells in cord blood.

Maternal and Neonatal Factors Associated with the High Yield of Mononuclear Low-Density/CD34+ Cells from Placental/Umbilical Cord Blood

“…These results are consistent with most of the previous reports (Donaldson et al 1999;Yamada et al 2000;Li et al 2001;George et al 2006;Mancinelli et al 2006), including that meconium in the amniotic fluid correlates with better cell counts (Askari et al 2005). Therefore the total LD cells per CB unit analyzed in the present study can be assumed as a substitute variable instead of the total nucleated cells in some previous studies (Lasky et al 2002;Mohyeddin Bonab et al 2004;Solves et al 2005), and can be also confirmed by other previous studies (Pafumi et al 2001;Bornstein et al 2005). In addition, the univariate analyses also show the significantly positive correlations between neonatal birth weight, placental weight, net weight of CB, and gestational age (Fig.…”

“…The number of samples is relatively smallscale compared to other data from CB banks. However, although there are some limitations due to the relatively small sample size, some previous studies were also analyzed by using small samples around 100 CB units (Donaldson et al 1999;Yamada et al 2000;Pafumi et al 2001). We therefore believe that our present study is appropriate to some extent.…”

Associated factors of umbilical cord blood collection quality

“…Neonates in the “upper position” group were placed on the maternal abdomen immediately after birth, while those in the “lower position” group were placed on the delivery table, below the maternal introitus. Effects of placing the newborn on the maternal abdomen after delivery are studied in two articles . These teams showed some positive effect in UCB volume, TNCs, and CD34 + cells of upper position compared to lowers.…”

The use of cord blood for transfusion purposes: current status

“…Besides the comparison of in or ex utero collection, seven studies applied a modified UCB collection technique [24,41–46]. In five of these studies it was investigated whether additional in or ex utero perfusion using heparinized NaCl or another anticoagulant resulted in a higher yield of UCB.…”

“…One other study compared the influence of position of the infant after birth on the in utero ‐collected UCB volume. When the newborn was kept above the level of the placenta before cord clamping, the harvested volume was significantly higher, compared to a lower position below the level of the placenta, 87·7 ± 14·5 ml vs. 41·7 ± 8·9 ml [24]. With each of the adaptations tested, the researchers were able to enlarge the harvested UCB volume (Table 5) [24,41–46].…”