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Published online: 2021-02-05
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Collection of umbilical cord blood and the risk of complications in postpartum women after natural labour in the context of the possibility of umbilical cord stem cells usage in clinical practice

Jakub Mlodawski, Marta Mlodawska, Natalia Przybysz, Aleksandra Bielak, Karolina Detka, Marcin Pasiarski, Wojciech Rokita
DOI: 10.5603/GP.a2020.0179
·
Pubmed: 33576474

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2021-02-05

Abstract

Objectives: Comparison of changes in peripheral blood venous morphology and the frequency of select complications in patients who underwent umbilical cord blood collection during the third stage of labour by in the utero method compared to patients who did not undergo this procedure. Presentation of current therapeutic possibilities of cord blood stem cells. Material and methods: The study involved 248 patients who had a vaginal delivery and had umbilical cord blood taken by in utero method during the third stage of labour. The control group consisted of the first 400 patients who gave vaginal delivery starting in 2019. Each patient had a venous peripheral blood count taken before delivery and 18 hours after delivery. Changes in the results of laboratory tests and the occurrence of adverse outcomes, such as postpartum curettage, postpartum haemorrhage and manual removal of placenta, in the 3rd and 4th stage delivery periods, were analysed. Results: In the blood donor group there were significantly lower haemoglobin (11.32 g/L vs 11.61 g/L, p = 0.004) and haematocrit (32.83% vs 33.82% p = 0.001) concentrations after delivery. Umbilical cord donors had a greater difference in haemoglobin (postpartum minus prepartum) (–1.4 g/L vs –0.9 g/L, p = 000), and haematocrit (–4.05% vs –2.5% , p = 0.000). The study group had a higher percentage of patients with postpartum anaemia (haemoglobin concentration < 10 g/L) (15.9% vs 10.64%, p = 0.05), but the result were borderline significant. The groups did not differ in terms of the percentage of postpartum curettage, PPH, manual removal of placenta, percentage of severe anaemia (Hb < 7g/L) or transfusion requirement. Conclusion: Collection of umbilical cord blood during the 3rd stage of labour using the in utero method is associated with a statistically significant increase of blood loss and a higher probability of postpartum anaemia. The observed changes are minor and may have little clinical significance in otherwise healthy patients.

Abstract

Objectives: Comparison of changes in peripheral blood venous morphology and the frequency of select complications in patients who underwent umbilical cord blood collection during the third stage of labour by in the utero method compared to patients who did not undergo this procedure. Presentation of current therapeutic possibilities of cord blood stem cells. Material and methods: The study involved 248 patients who had a vaginal delivery and had umbilical cord blood taken by in utero method during the third stage of labour. The control group consisted of the first 400 patients who gave vaginal delivery starting in 2019. Each patient had a venous peripheral blood count taken before delivery and 18 hours after delivery. Changes in the results of laboratory tests and the occurrence of adverse outcomes, such as postpartum curettage, postpartum haemorrhage and manual removal of placenta, in the 3rd and 4th stage delivery periods, were analysed. Results: In the blood donor group there were significantly lower haemoglobin (11.32 g/L vs 11.61 g/L, p = 0.004) and haematocrit (32.83% vs 33.82% p = 0.001) concentrations after delivery. Umbilical cord donors had a greater difference in haemoglobin (postpartum minus prepartum) (–1.4 g/L vs –0.9 g/L, p = 000), and haematocrit (–4.05% vs –2.5% , p = 0.000). The study group had a higher percentage of patients with postpartum anaemia (haemoglobin concentration < 10 g/L) (15.9% vs 10.64%, p = 0.05), but the result were borderline significant. The groups did not differ in terms of the percentage of postpartum curettage, PPH, manual removal of placenta, percentage of severe anaemia (Hb < 7g/L) or transfusion requirement. Conclusion: Collection of umbilical cord blood during the 3rd stage of labour using the in utero method is associated with a statistically significant increase of blood loss and a higher probability of postpartum anaemia. The observed changes are minor and may have little clinical significance in otherwise healthy patients.

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Keywords

cord blood; private banking; public banking; delayed cord clamping; stem cells; perinatal care

About this article
Title

Collection of umbilical cord blood and the risk of complications in postpartum women after natural labour in the context of the possibility of umbilical cord stem cells usage in clinical practice

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-02-05

DOI

10.5603/GP.a2020.0179

Pubmed

33576474

Keywords

cord blood
private banking
public banking
delayed cord clamping
stem cells
perinatal care

Authors

Jakub Mlodawski
Marta Mlodawska
Natalia Przybysz
Aleksandra Bielak
Karolina Detka
Marcin Pasiarski
Wojciech Rokita

References (20)
  1. Gluckman E, Broxmeyer HA, Auerbach AD, et al. Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling. N Engl J Med. 1989; 321(17): 1174–1178.
  2. Amat L, Sabrià J, Martínez E, et al. Cord blood collection for banking and the risk of maternal hemorrhage. Acta Obstet Gynecol Scand. 2011; 90(9): 1043–1045.
  3. Organization World Health. WHO. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. ; 2014.
  4. McDonald SJ, Middleton P, Dowswell T, et al. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev. 2013(7): CD004074.
  5. Andersson O, Lindquist B, Lindgren M, et al. Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age. JAMA Pediatrics. 2015; 169(7): 631.
  6. Fogarty M, Osborn DA, Askie L, et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol. 2018; 218(1): 1–18.
  7. Qian Y, Ying X, Wang P, et al. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes. Arch Gynecol Obstet. 2019; 300(3): 531–543.
  8. Ciubotariu R, Scaradavou A, Ciubotariu I, et al. Impact of delayed umbilical cord clamping on public cord blood donations: can we help future patients and benefit infant donors? Transfusion. 2018; 58(6): 1427–1433.
  9. Rogers I, Holt D, Macpate F, et al. Human UC-blood banking: impact of blood volume, cell separation and cryopreservation on leukocyte and CD34(+) cell recovery. Cytotherapy. 2001; 3(4): 269–276.
  10. Allan DS, Scrivens N, Lawless T, et al. Delayed clamping of the umbilical cord after delivery and implications for public cord blood banking. Transfusion. 2016; 56(3): 662–665.
  11. Broxmeyer HE, Lee MR, Hangoc G, et al. Hematopoietic stem/progenitor cells, generation of induced pluripotent stem cells, and isolation of endothelial progenitors from 21- to 23.5-year cryopreserved cord blood. Blood. 2011; 117(18): 4773–4777.
  12. Dessels C, Alessandrini M, Pepper M. Factors Influencing the Umbilical Cord Blood Stem Cell Industry: An Evolving Treatment Landscape. STEM CELLS Translational Medicine. 2018; 7(9): 643–650.
  13. Poltranasplant. Biuletyn informacyjny nr 2 ISNN 1428-0825 28.07.2019.
  14. Ballen KK, Verter F, Kurtzberg J. Umbilical cord blood donation: public or private? Bone Marrow Transplant. 2015; 50(10): 1271–1278.
  15. Aziz J, Liao G, Adams Z, et al. Systematic review of controlled clinical studies using umbilical cord blood for regenerative therapy: Identifying barriers to assessing efficacy. Cytotherapy. 2019; 21(11): 1112–1121.
  16. Sun JM, Song AW, Case LE, et al. Effect of Autologous Cord Blood Infusion on Motor Function and Brain Connectivity in Young Children with Cerebral Palsy: A Randomized, Placebo-Controlled Trial. Stem Cells Transl Med. 2017; 6(12): 2071–2078.
  17. Abo-Elkheir W, Hamza F, Elmofty AM, et al. Role of cord blood and bone marrow mesenchymal stem cells in recent deep burn: a case-control prospective study. Am J Stem Cells. 2017; 6(3): 23–35.
  18. Wynne B. American College of Obstetricians and Gynecologists (ACOG). Encyclopedia of Global Health. .
  19. Poręba R, et al. Czajka R., Czajkowski K. Opinia Zespołu Ekspertów Polskiego Towarzystwa Ginekologicznego w sprawie pobierania i deponowania komórek macierzystych krwi pępowinowej. ; 2010.
  20. 1756 Dz.U. 2018 poz. Rozporządzenie Ministra Zdrowia z dnia 16 sierpnia 2018 r. w sprawie standardu organizacyjnego opieki okołoporodowej.

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