Obstetrics and Gynaecology Unit, Di Venere Hospital, Bari, Italy.
Blood Transfus. 2011 Jul;9(3):286-91. doi: 10.2450/2011.0038-10. Epub 2011 Apr 7.
The aim of this study was to analyse umbilical cord blood (UCB) collection over 1 year between October 2008 and September 2009, seeking ways to improve the number of suitable banked UCB units. Four phases of the process were investigated, from the consent form to the banking procedure, paying attention to the discarded UCB units.
We recruited couples at 35 weeks of gestation and took an accurate history, focusing on genetic, immunological and infectious diseases. We collected UCB from pregnant women who delivered vaginally or by Caesarean section between the 37-41(+6) weeks of gestation. Some units were discarded on the basis of the patients' history, obstetric events or biological criteria. In utero collection was the preferred method of collection.
During the study period, between October 2008 and September 2009, there were 1,477 deliveries in our unit. The number of couples interested in UCB donation was 595 (40.2%-595/1,477). We collected 393 UBC units. We excluded 122 patients at the phase of the history taking, counselling and informed consent (first phase check). Of the 393 units collected, 162 (41.3%) were banked whereas 231 (58.7%) were discarded because they did not fulfil biological criteria (third phase check). The volume of UCB units collected after Caesarean section was greater than the volume of units collected after vaginal delivery (95.4 mL versus 85.0 mL, respectively; p <0.01). The UCB units collected after vaginal delivery contained a higher number of total nucleated cells compared to the units collected after Caesarean section (970x10(6) cells versus 874x10(6) cells, respectively; p=0.037). None of the banked UCB units was discarded at the clinical check 6 months after delivery (fourth phase check).
Our study shows that strict observance of each of the checks and the collection strategy is important to guarantee the safety of the UCB units and to maximise the cost-benefit ratio. After the appropriate checks we banked UCB units from only 27.2% (162/595) of the couples who gave consent to the procedure and from only 11% (162/1,477) of all the deliveries in the 12 month study period, as 59.8% of couples were not properly informed about UCB donation.
本研究的目的是分析 2008 年 10 月至 2009 年 9 月期间的脐带血（UCB）采集情况，以寻找提高储存 UCB 数量的方法。本研究对四个阶段的过程进行了分析，从同意书到储存程序，同时关注废弃的 UCB 单位。
我们在 35 周妊娠时招募了夫妇，并进行了详细的病史采集，重点关注遗传、免疫和传染病。我们从阴道分娩或剖宫产的 37-41（+6）周妊娠的孕妇中采集 UCB。一些单位是根据患者的病史、产科事件或生物标准而被丢弃的。宫内采集是首选的采集方法。
在研究期间，即 2008 年 10 月至 2009 年 9 月期间，我们单位共有 1477 例分娩。对 UCB 捐献感兴趣的夫妇有 595 人（40.2%-595/1477）。我们收集了 393 个 UBC 单位。我们在病史采集、咨询和知情同意阶段（第一阶段检查）排除了 122 名患者。在收集的 393 个单位中，有 162 个（41.3%）被储存，而 231 个（58.7%）因未达到生物标准（第三阶段检查）而被丢弃。剖宫产采集的 UCB 单位体积大于阴道分娩采集的单位体积（分别为 95.4 毫升和 85.0 毫升；p<0.01）。与剖宫产采集的 UCB 单位相比，阴道分娩采集的 UCB 单位中总核细胞数量更多（分别为 970x10(6)个细胞和 874x10(6)个细胞；p=0.037）。产后 6 个月的临床检查（第四阶段检查）没有丢弃任何储存的 UCB 单位。
我们的研究表明，严格遵守每一个检查和采集策略对于保证 UCB 单位的安全性和最大化成本效益比非常重要。在适当的检查后，我们只从同意该程序的夫妇中储存了 27.2%（162/595）的 UCB 单位，只从 12 个月研究期间的所有分娩中储存了 11%（162/1477）的 UCB 单位，因为 59.8%的夫妇没有得到适当的 UCB 捐赠信息。
