Diagnosis of acute foetal distress does not preclude banking of umbilical cord blood units

Abstract

Clinical diagnosis of acute foetal distress (AFD) is based on several parameters such as abnormal foetal heart rate (FHR) pattern and/or meconium liquid staining (MLS). Standards for cord blood (CB) banking indicate that AFD should be considered as exclusion criteria for CB collection, but precise guidelines on how to proceed with CB collection in the presence of AFD signs during labour are not available. We evaluated whether the presence of FHR abnormality and/or MLS during labour 1) reduced the CB collection activity; 2) were associated with the infant's acidaemia or asphyxia and 3) deteriorated the biological characteristics of CB units. Thirty-three units of CB were evaluated for biological parameters, gas values and newborn's Apgar score. The results were compared with a control group of 33 consecutive units previously banked. No differences were observed between the two groups and all but one newborn showed normal Apgar score and absence of metabolic acidaemia. The results showed that 1) AFD reduced the CB collection activity by 10% each year; 2) the majority of CB units collected in the presence of abnormal FHR and/or meconium have biological characteristics eligible for banking; 3) FHR alterations or meconium in the presence of normal gas analysis do not represent certain diagnosis of AFD.

Stress factors and umbilical cord blood banking

“…In fact, it has been shown that with the increase in gestational age, volume and TNC counts of UCB collections increase, but percentage of CD34 + cells decreases, while maintaining total CD34 + cell and colony‐forming unit values (Shlebak et al , 1998). Our results differ from those published by Picardi et al (2006) who did not find any difference in UCB parameters between deliveries with and without stress factors. Maybe, the low number of cases in this study could explain it.…”

“…We have read with interest the recently published article by Picardi et al (2006) about acute foetal stress and umbilical cord blood (UCB) banking. Inclusion/exclusion obstetrical criteria are not standardized and differ among UCB banks.…”

Sang de cordon ombilical : Counseling, prélèvement et mise en banque

“…L'utilisation de grosses seringues (de 50 à 60 cm 3 ) et le recours à une technique particulière (remplissage de la seringue au moyen d'une solution saline, éjection de la solution saline, puis prélèvement du sang de cordon au moyen de la seringue) dans le cadre du système fermé de prélèvement ont permis l'obtention d'un volume moyen considérablement plus élevé (150-175 ml), par comparaison avec la technique standard de prélèvement in utero par gravité (75-100 ml). Il a également été signalé que le clampage du cordon ombilical dans les 30 secondes suivant l'accouchement et le fait de placer le nouveau-né sur l'abdomen de la mère après l'accouchement permettaient d'accroître le volume récupéré et la numération de cellules CD34þ 63,64 ; toutefois, ce clampage précoce empêche l'obtention des avantages associés au clampage différé.…”

Umbilical Cord Blood: Counselling, Collection, and Banking

“…Using large syringes (50 to 60 cc) and a syringe withdrawal-saline flush-syringe withdrawal technique as part of the closed collection system have yielded significantly higher mean volume collected (150 to 175 mL), compared with standard in utero collection by gravity (75 to 100 mL). Clamping the umbilical cord within 30 seconds of delivery and placing the newborn infant on the maternal abdomen after delivery have also been reported to improve recovery volume and CD34+ cell content; 63,64 however, this early clamping defeats the benefits of delayed clamping.…”