Placental Blood Collection

Placental blood collection is done today by standard methods and can be performed regardless of the particulars of the birth (vaginal birth by both normal and pathological presentation, by caesarean surgery or twins / multiple pregnancy). Even in cases of non-standard births: preterm birth, over term pregnancy, water birth placental blood collection can be performed. Epidural anaesthesia or administration of medicines in the prenatal period or during birth, for various diseases of the mother or for pregnancy complications (e.g. preeclampsia, hypertension in pregnancy, pregnancy related diabetes) are not contraindications for collection.

Placental blood collection is performed by the obstetrician who attends the birth.

Absolute contraindications for collecting cord blood: maternal HIV infection, active syphilis, acute infections or active clinical forms of chronic infection with HBV and HCV (B and C hepatitis), infection contacted during pregnancy with Toxoplasma Gondi, rubella virus, cytomegalovirus Relative Contraindications: the state of inactive chronic carrier of HBV or HCV

In the event of obstetric complications during birth, the obstetrician is the one who decides whether it is appropriate or not to collect placental blood, maternal and infant security being most important.

Fetus expulsion and termination of the last "beats" of the cord, is followed by the cut of the umbilical cord and infant separation from it (the pulsations of the umbilical cord blood are the latest emission from the mother toward the fetus). While the infant is taken by midwives and provided the first necessary aid, the doctor performs the procedure for collecting placental blood before the placenta is expelled (eliminated) from the uterus.

Collecting procedure :
After a preliminary thorough washing of the umbilical cord with sterile saline the puncture area is disinfected - by spraying an active surface on its surface. Then, the spiral umbilical vein is pierced with the catheter attached to the harvesting kit.
Finally, the proper placental blood collection.

Cleaning and disinfecting the umbilical cord is a necessary step to minimize possible contamination of placental blood with different microorganisms which are, normally, in the vaginal flora (genitor-anal area) or in rare cases with pathogen germs existing in the amniotic fluid, skin and mucous membranes. By applying these preventive measures, the incidence of contamination of samples is reduced to 2-3% of the cases.

In the case of twins, it is important to clarify if the pregnancy is monocorial (with a single placenta) or bicorial (with 2 placentas). In the first case a single collection kit is sufficient and in the second, two collection kits are needed, the collection being performed from each umbilical cord and from each placenta, in part.
The procedure consists in the collection of the blood volume remaining in the umbilical cord (3%) and especially, in the placenta (97% of the total collected quantity), after the last emissions of blood from the mother towards the fetus took place. The amount of the collected blood can vary widely (between 20 to 100 ml, 150 ml rarely) and the concentration of nucleated cells reported in the same volume of blood collected, may be different from one birth to another. These quantitative parameters may be considered as individual for each collection separately, and is strictly dependent only on the dynamics of the birth.
The evaluation of these quantitative parameters is necessary in view of the clinical transplant activity. In general, quantitative parameters of cord blood grafts meet the criteria necessary to perform a transplant in the best conditions for children and adolescents with haematological malignancies. The experience gained in the recent years, through the application of various ways of increasing the number of available stem cells, allowed the extension of the indications to perform a transplant with cord blood grafts for adults or for non-malignant haematological disorders, too, the number of cord blood transplantation with grafts carried out annually reaching 2000-3000. Thus, medical studies have proven the efficient clinic initial association of a placental blood graft with an additional bone marrow graft, peripheral blood or another placental blood graft. Also, there are encouraging clinical results reported so far on efficient and safe application of techniques of cell expansion on placental blood grafts, before performing transplantation. These issues are evaluated by the careful monitoring of patients who are carefully selected to participate in medical studies that are in progress.

The increased scientific interest on the expansion of the possibilities of using cord blood grafts, is also due and to specific peculiarities of this source of hematopoietic stem cells. Placental blood grafts have the advantage of being easily collected, rapidly available and owning immunological peculiarities associated with transplantation.(see more details - placental blood).