Cord Blood Specimen Collection Guide

COLLECTING UMBILICAL CORD BLOOD SPECIMEN

This information has been provided for the Doctor, Midwife and Healthcare Professional who has been asked to collect the Umbilical Cord Blood sample on behalf of our newly expectant client at this very special time in their lives.

Cells Limited is the leading provider for the safe storage of stem cells. We provide storage of cord tissues and stem cells extracted from the umbilical cord blood of the newborn.

The umbilical cord or placenta is a rich source of stem cells. These cells can help cure many life threatening diseases. The main use so far has been for blood disorders but potentially these cells could be used to treat illnesses such as diabetes, strokes, multiple sclerosis, brain and muscle diseases, Alzheimer's Parkinson’s disease and heart muscle cells.

The Doctor, Midwife, Healthcare professional collecting the umbilical cord blood sample plays an important role at this crucial time as these samples can only be collected at the time of birth.

In this leaflet you will find a step by step guide on how to collect the umbilical cord blood sample. The procedure is very simple and quick. It takes no more than few minutes and is completely painless and bares no harm to the child or the mother as it takes place following the safe delivery of the baby and only after the umbilical cord has been cut.                                                                                                                        The mother/birthing partner sign a disclaimer so that the Doctor, Midwife, Healthcare Professional performing the collection of cord blood and cord samples will not be held liable if due to unforeseen circumstances the collection of the sample (s) was not possible or the amount of cord blood taken proves to be insufficient.

Finally, it is hoped that the cord blood stem cells will never have to be used, but in the unlikely event of this happening the family can rest assured with the knowledge that they have their baby’s stem cells safely stored and available for immediate use.

A GUIDE FOR THE HEALTHCARE PROFESSIONALS COLLECTING UMBILICAL CORD BLOOD SPECIMEN
PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY

Collection must only take place AFTER the cord has been clamped and cut and the Mother and Baby are confirmed safe by the Doctor/Midwife.

Thank you for agreeing to collect the umbilical cord blood. This simple procedure can be performed IN-UTERO or EX-UTERO and normally takes no more than a few minutes. The same method is used for either. It is preferable, if safe to do so, that this procedure is performed IN-UTERO as it has the added advantage of the placenta still pulsating which can help pump blood through the cord into the collection bag. If the cord blood is to be collected EX-UTERO it should be performed as soon as it is safely possible once the placenta has been delivered before the natural clotting process begins. (This needs to be taken into consideration when a physiological delivery of the placenta takes place as the natural clotting process may reduce the amount of cord blood available for collection. Every effort should be made to collect as much cord blood as possible for the successful storage of stem cells.

The procedure for a caesarean section is the same as it would be for a natural birth EX-UTERO.

The healthcare professional collecting the sample must be guided by the Doctor/Midwife attending the delivery. Consideration must also be given to the mother’s wishes.

CRYOCORD KIT

Cryo-Save approved CryoCord Kit is used for collection of Umbilical Cord Blood and Maternal Blood samples; its contents are as follows:


1 Single blood-pack unit with needle protector:

· 1.6mm (16GA) needle

· Each unit consists of a primary pack containing 35ml CPDA-1 anticoagulant solution for collection of 250ml of blood.

1 Sterile blister containing:

· Sterile gauze swabs 7.5x7.5cm

· Cleansing wipes

· One Pair of scissors

· One Pincette and one Operation field

1              Absorbing cloth (obligation for transportation)

1              95 kPa plastic bag with hermetic quick lock

2              Gel packs for temperature control during transportation

1              Polystyrene box for transportation

Maternal Blood Collection Kit

1 Serum Monovette

1              Safety Needle for Serum Monovette (including adapter).

Additional Items

Client ID stickers provided in a separate envelope are to be pasted on cord blood bag, cord tissue tube and maternal blood monovette.

Documentation

Following documents/items are also provided with the kit separately to facilitate procurement process


1              Procurement Form (To be completed and signed by the concerned obstetrics consultant/phlebotomist who performs the collection. The completed form should be handed over to the parents for sending it back to Cells Limited offices in Harrow, UK).

1              A Copy of this Collection Guide for the information of the obstetrics consultant/phlebotomist.

1              Client Identification Form (To be completed by the parents and sent with the sample)

1              Sending Procedure explaining shipment by DHL courier.

1              DHL Courier Clear bag (Clear Flyer) along with DHL Shipment Air Waybill.

 

UMBILICAL CORD BLOOD COLLECTION PROCEDURE

This simple procedure must be done in a sterile environment as soon as possible after the safe delivery of the baby and after the cord has been clamped; please ensure that the cord is clamped as close to baby’s abdomen as safe to do so.


PLEASE ENSURE THAT THE CORD REMAINS CLAMPED AT ALL TIMES.

Collecting Umbilical Cord Blood Sample: IN-UTERO

 


STEP ONE


· Take the sterile blood bag out of its packaging and place nearby.

· Clean the umbilical cord with the sterile gauze.

· Disinfect the areas where the needle will be inserted. (a sterile environment is a must).

 

Collecting Umbilical Cord Blood Sample: EX-UTERO

 

STEP ONE


· Prepare the work surface where the cord blood collection will be performed.

· Take the sterile blood bag out of its packaging.

· Place the placenta on a sterile cloth and allow the umbilical cord to hang down over the

side. (Gravity can play an important part in this procedure).

· Clean the umbilical cord with the sterile gauze.

· Disinfect the areas where the needle will be inserted. (a sterile environment is a must)

 

STEP TWO (IN-UTERO AND EX-UTERO)

 

· The needle is covered with a blue cap, remove it.

· Starting at the end of the clamped cord insert the needle attached to the blood bag into the disinfected blood vessel.

· Allow the cord blood to flow into the collection bag to collect as much blood as possible;

this may take a few minutes.

· If the cord blood does not flow, very gently turn the needle (the bevel of the needle may

be resting on the vessel wall) this should allow the blood to flow.

· If the cord blood still fails to flow, remove the needle from the vessel and insert into the

next disinfected vessel further up the cord.

· Gently agitate the collection bag during the procedure in order to mix the cord blood

with the CPD anticoagulant.

· It may be necessary to draw blood from several places in the umbilical cord. Please ensure that these areas have been properly sterilised beforehand.

 

STEP THREE (IN-UTERO AND EX-UTERO)

 

· Once the collection bag is full and the blood flow has stopped, remove the needle from the umbilical cord.

· Strip the blood through the tube into the blood bag with the attached white clamp    securely close the white clamp approx 10cm (4 inches) from the bag.

· Cut off the needle and safely discard into a sharps box in accordance with hospital waste disposal regulations.

· Tie at least two security knots in the collection tube to prevent leakage during transportation (do not use sutures for this).

· Stick one of the Client ID stickers on to the cord blood bag.

Maternal Blood Collection

Shortly before or after the birth take a small tube of blood from Mother:

· For this collection, use the Serum Monovette and Safety Needle provided.

· Minimum of 7.5 ml blood specimen is required.

· Stick one of the Client ID stickers on to the Serum Monovette.

· Place the filled Monovette in the Grip Seal plastic bag provided and then pack it along with the cord blood sample in the pathoseal for transportation.

Collecting Maternal Blood

Maternal blood sample is to collect using the Serum Monovette and Safety Needle provided and in keeping with the institutional policy; following may serve as a guideline and either procedure may be used:


Aspiration Procedure

 

· Assemble Serum Monovette and Needle

· Puncture vein, loosen tourniquet and draw up the blood.

· Remove the Serum Monovette from the needle

· Finally remove the needle from the vein.

· Withdraw the piston past the stop mark and lock into the base of the Serum Monovette

and then snap off piston rod.

· Mix the Serum Monovette thoroughly with Antigualant.

Vacuum Procedure

· Prior to blood collection, lock the piston into the base of the Serum Monovette

· Once secured, snap off the plunger

· Insert this prevaccuated Serum Monovette on to the Needle already located in the Vein.

· After collection of the blood, remove the Serum Monovette from the needle  and thoroughly mix the Serum Monovette with Antigualant.

· Gently remove the needle from the vein.

 

PLEASE NOTE FOR TWINS

· In the event of twins, the entire process for collection of cord blood and cord tissue to repeated using a separate collection kit for each child. (Each kit will be labelled twin 1 and twin 2).

· However, maternal blood specimen should be taken once only and should be identified by pasting appropriate label provided with the kit and client id sticker should be pasted after collection.

· It is critical to clearly identify the baby source of each cord collection bags for both twins.

PREPARING FOR TRANSPORTATION

· Place the cord blood bag onto the absorbent cloth and put them into the small safety bag (pathoseal). Also place the Monovette containing maternal blood sample before closing this safety bag with the self-adhesive strip.

· Place the safety bag (pathoseal) on top of the bottom Gelpack.

· Place the second Gelpack on top of the safety bag (pathoseal).

· Close with the isolating lid.

· Now enclose the completed Identification Form.

· Close the cardboard box.

· Put the cardboard box in the DHL courier bag (clear flyer) and leave it open.

· Finally, complete the supplied DHL Shipment Air Waybill (only pick up address, name and signature, other sections will be completed by the courier).

· Give the Package containing the Samples and completed Procurement Form back to the parents who will then contact the courier for transportation following the Sending Procedure provided with the kit instructions.

· Procurement Form is to be completed and signed by the concerned Obstetrics Consultant/Phlebotomist, and sent to Cells Limited in the self addressed/stamped envelope provided with the kit instructions.


The ready pack containing umbilical cord blood and maternal blood samples for transportation should be kept at the room temperature while waiting for the DHL courier to arrive.

 


THANK YOU