Umbilical cord blood collection before placental delivery during cesarean delivery increases cord blood volume and nucleated cell number available for transplantation

Surbek, Daniel; Visca, E.; Steinmann, Christian; Thewis, André; SCHATTA, S; Hahn, Sinuhe; GRATWOHL, A; Holzgreve, Wolfgang

doi:10.1016/s0002-9378(00)18148-7

Cited by 57 publications

(26 citation statements)

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“…Other authors have confirmed a larger CB volume and more total nucleated cells were obtained in the samples collected before placental expulsion for caesarean deliveries. 15 However, our conclusions differ from those recently reported by Sparrow et al who did not find differences between the two ways of collection for vaginal deliveries, or between vaginal and caesarean deliveries, although there was a trend towards a higher cell concentration and collected volume for in utero collections 16 . The limited number of cases (99 ex utero vs 58 in utero) could account for a lack of statistical power.…”

Section: Discussioncontrasting

confidence: 99%

Comparison between two strategies for umbilical cord blood collection

Solves¹,

Moraga

Saucedo

et al. 2003

Bone Marrow Transplant

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Summary:The use of cord blood (CB) for transplantation has increased greatly in recent years. The collection strategy is the first step in collecting good-quality CB units. There are two main techniques for collecting CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB bank trained personnel. In this study, the benefits and disadvantages between the two different CB collection strategies were evaluated, in order to improve CB bank methodology. Valencia CB bank maintains the two different collection strategies. CB was obtained from 569 vaginal and 70 caesarean deliveries and obstetrical and clinical charts were reviewed. Before processing CB units, volume was calculated and samples were drawn for cell counts. After processing and before cryopreservation samples were drawn for cell counts, CD34+cell analysis, viability, clonogenic assays and microbiology were drawn directly from the bags. We compared the efficiency of the two collection techniques. Obstetric data and umbilical CB were obtained from 569 vaginal (264 collected in utero and 305 collected ex utero) and 70 caesarean deliveries. The proportion of excluded CB units before processing was 33% for vaginal ex utero, 25% for vaginal in utero and 46% for caesarean deliveries. Differences were statistically significant. For vaginal deliveries a larger volume and a higher number of nucleated cells, percentage of CD34+ cells and colony-forming units (CFUs) were harvested in the in utero collection group. There was no statistical difference between CB collected after placental expulsion from vaginal and caesarean deliveries. Comparison between all vaginal and caesarean deliveries did not show any difference. We conclude that the mode of collection influences the haematopoietic content of CB donations. Collection before placental delivery is the best approach to CB collection and allows optimisation of CB bank methodology. Caesarean deliveries seem to contain similar progenitor content to vaginal deliveries.

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Section: Discussioncontrasting

confidence: 99%

Comparison between two strategies for umbilical cord blood collection

Solves¹,

Moraga

Saucedo

et al. 2003

Bone Marrow Transplant

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“…In fact, consistent with previous studies on UCB collection after vaginal delivery, the compression of the placenta induced by uterine contractions forces blood to flow by gravity from the placenta into a sterile collection bag [28]. Moreover, collection of fetal cord blood before placental detachment is possible without a significant negative effect on maternal blood loss, surgery time and infection incidence [25].…”

Section: Discussionsupporting

confidence: 76%

“…By clamping in fact UCB at an early stage, we obtained a greater number of CD34+ and their activity increased with enrichment (MiniMac System particularly provides us 54% of colonies with a 90% purity against 35% with a 80% purity of the Stem Sep method). In the end, sufficient data are not available yet for UCB collected during cesarean section, and past studies [25] tried to determine whether UCB collection during cesarean delivery can be improved by collecting cord blood before placental delivery. Forty patients undergoing cesarean section were randomly assigned to one of two groups and a larger amount of cord blood volume and a higher total nucleated cell number was obtained in the samples collected before placental delivery.…”

Section: Introductionmentioning

confidence: 99%

Differences in Umbilical Cord Blood Units Collected during Cesarean Section, before or after the Delivery of the Placenta

Pafumi

Farina²,

Bandiera³

et al. 2002

Gynecol Obstet Invest

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Umbilical cord blood is largely employed as an alternative source of stem cells in the treatment of hemato-oncological diseases. Current results show that the success rate of purified umbilical cord blood engraftment is comparable to that obtained using bone marrow, and it is directly related to the number of pluripotent stem cells transplanted. The technique of fetal blood collection varies among different umbilical cord blood banks. Many authors collect umbilical cord blood during vaginal delivery, after placental detachment, while others collect it while the placenta is still within the uterus. In a previous randomized trial, we showed a greater collection of umbilical cord blood before placental detachment during vaginal delivery. The present study was performed to determine whether umbilical cord blood collection before placental detachment (group A) during cesarean section is superior to that after placental delivery (group B) puncturing the umbilical vein once and using a closed bag system. To accomplish this, 47 pregnant women subjected to cesarean section were enrolled in the study. Twenty-one of them were allocated to group A, while the remaining 26 formed group B. The volume of umbilical cord blood collected from the patients of group A was greater than that collected from patients of group B. The cord blood volume collected was 90.7 ± 6.0 versus 60.9 ± 13.7 ml; the cord blood nucleated cell number was 10.1 ± 1.2 × 10⁸ vs. 7.1 ± 0.8 × 10⁸; and the mean cord blood CD34+ cell number was 20.0 ± 6.0 × 10⁵ vs. 16.4 ± 2.4 × 10⁵, respectively.

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“…8,9 Studies performed on healthy pregnancies have shown that gestational and obstetric factors, including maternal age, parity, gestational age, length of labor, stress during labor, route of delivery, technique of UCB collection and positioning of the newborn after delivery can influence the numbers of HSC in UCB obtained after delivery. [10][11][12][13][14] A younger maternal age, shorter gestational age and shorter time from collection to processing were associated with higher CD34 + HSC counts. 14 Neonatal characteristics, including gender and weight of the newborn, may also influence the numbers of HSC in UCB.…”

Section: Introductionmentioning

confidence: 97%

Effects of preeclampsia on the yield of hematopoietic stem cells obtained from umbilical cord blood at delivery

Fadilah

Nasaruddin²,

Idris

et al. 2012

J of Obstet and Gynaecol

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Aim: To compare the numbers of cord blood CD34+ hematopoietic stem cells (HSC) between preeclampsia (PE) and control (non-PE) subjects and to determine the factors that may influence this observation. Methods: Umbilical cord blood was collected from 28 PE and 19 non-PE subjects. Nucleated and CD34+ cell counts were derived using the Trucount tube-based stem cell enumeration kit on BD FACSCalibur. Results: The cord blood volume, nucleated and CD34+ cell counts were significantly reduced in PE subjects compared to non-PE subjects. Among the PE subjects, systolic and diastolic blood pressure demonstrated a negative correlation with total nucleated and CD34 + cell counts. Gestational age at delivery influenced cord blood volume and nucleated cell counts, but not CD34 + cell counts. Birth weight and placental weight correlated strongly with cord blood volume, and nucleated and CD34 + cell counts. There were no correlations observed between cord blood parameters and maternal age, maternal white cell count, gravidity, route of delivery or neonatal gender among PE subjects. Conclusion: Preeclampsia has a negative impact on the yield of HSC obtained from cord blood at delivery. Maternal blood pressure, neonatal birth weight and placental weight are important factors influencing the numbers of cord blood HSC. These findings should be taken into consideration when selecting cord blood units from mothers with PE for banking. Selecting the heaviest term neonate might improve the yield of cord blood HSC obtained from PE mothers.

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Umbilical cord blood collection before placental delivery during cesarean delivery increases cord blood volume and nucleated cell number available for transplantation

Cited by 57 publications

References 0 publications

Comparison between two strategies for umbilical cord blood collection

Comparison between two strategies for umbilical cord blood collection

Differences in Umbilical Cord Blood Units Collected during Cesarean Section, before or after the Delivery of the Placenta

Effects of preeclampsia on the yield of hematopoietic stem cells obtained from umbilical cord blood at delivery

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