Instructions for Cord Blood and Tissue Collection

Instructions for Cord Blood Collection In-Utero and Ex-Utero

 

 

IMPORTANT: PRIOR TO COLLECTION

  • There shall be no alteration in the standard medical procedures for the management of labour in order to accommodate for a difficult or problematic umbilical cord blood collection
  • The collection shall not be attempted in cases where the attending clinician believes it to be contraindicated: this will be likely to include all premature births and cases where the doctor believes that during labour there appear to be specific contraindications, such as nuchal cord or maternal haemorrhage.
  • Ensure and verify that consent for the collection has been granted.
  • Ensure that the collection kit bears a unique tracking code
  • Ensure that the collection kit belongs to the parents (Lifeline clients); a means of confirming identity of donor
  • Complete or review the parents medical history on the back of Form C (F-ADM09/03)
  • Indicate whether the any antimicrobial therapy has been prescribed in the last 7 days
  • Indicate whether the mother is healthy on her delivery date. If the mother had any type of health problems (e.g. infection) on the date of her delivery please record this on the document.

 

AT THE DELIVERY ROOM / OPERATING THEATRE

 

Open the Life-Kit and you will find the collection bag inside. Do not use this collection bag, if it has been damaged, if the anticoagulant is not in liquid form, or if the collection bag is expired.

 

CAUTION: Avoid holding the collection bag from the blue covers as to prevent them from automatically securing the needles prior to the collection. Nevertheless, in such an event, the needles can be freed with the use of a clamp.

 

Collection of Maternal Blood Sample: Ensure that maternal blood sample has been collected for serological testing. Use the two red top vacutainer tubes, syringe, needle and alcohol swabs provided in the Life-Kit for the collection of the maternal blood sample.

 

CORD BLOOD COLLECTION PROCEDURE:

  1. Following the clamping and separation of the infant from the umbilical cord, wipe-clean any maternal blood off the umbilical cord using a gauze soaked in alcohol or an iodine-based antiseptic liquid for at least 30 seconds at the venipuncture site (vein)
  2. Allow the venipuncture site to dry. Decontamination/sterilization of the cord at the puncture site is very important as it will prevent any contamination of the cord blood.
  3. Place the collection bag at a lower level to enable the free flow of blood into the bag.
  4. Remove the needle covers and keep near-by as you will need to recap at the end of the collection.
  5. Puncture the vein at the sterilized site of the umbilical cord and allow the blood to flow out into the collection bag. Massaging the umbilical cord during collection will allow better blood flow.
  6. In the event that blood flow stops, please proceed to the sterilization of another site closer to the placenta and use the second needle for further blood collection.
  7. If insufficient blood has been collected, it is possible to obtain more blood following the delivery of the placenta (ex-utero as described in 11 below)
  8. Please try to collect as much cord blood as possible; please be informed that 40ml of cord blood is the lowest acceptable volume. However, regardless the volume of cord blood collected, the sample must be sent to Lifeline for a final evaluation.
  9. During the collection process the collection bag must be agitated gently to achieve good mixing of blood with the anticoagulant and to prevent the formation of clots. At the end of the collection procedure, the blue clamps must be tightened and the needles must be covered using the saved covers to prevent the piercing of the collection bag and prevent any needle accidents incurring to laboratory personnel. By simply pulling the blue covers over the needles, these will secure automatically.
  10. In the case of a caesarian labor the collection procedure is carried out in the same way as with a natural/vaginal delivery.
  11. In the event that the placenta is delivered before the cord blood collection it is acceptable to perform cord blood collection ex-utero.  This can be achieved by placing the placenta in a sterile container and draw blood in the same way as in-utero. Placing the blood bag at a lower level, will enable blood to flow freely by gravity. Same procedure for disinfection/decontamination applies to ex-utero collection.
  12. Ensure that all information on Form C has been completed (date and time of birth, medications taken by the mother up to 7 days prior to delivery date, etc.). Complete or review the Medical history of the parents, found on the back of Form C (F-ADM09/03).
  13. In a zip-loc bag you will find a label with the Life-Kit tracking code. Please affix this label onto the collection bag, place the collection bag inside the zip-lock bag, close securely and place it into the Life kit box.
  14. Complete the label found on the outside of the Life-kit box.
  15. Deliver the Life-Kit box to the person appointed by the parents responsible for arranging the transportation of the kit to Lifeline laboratory.

 

ADVERSE REACTIONS

  • In the event that an adverse reaction occurs during the collection and is attributed or there are suspicions that are attributed to the procurement (collection) procedure, please complete the F-SOP-08/2 Notification of Adverse Reaction at Procurement Form.

 

INSTRUCTIONS FOR THE COLLECTION OF UMBILICAL CORD SECTION

  • Collection of umbilical cord section shall be performed ex –utero
  • Using sterile gauze wipe the length of umbilical cord to remove fluids and blood
  • Using the provided sterile swab soaked in 70% ethanol, disinfect well the length of the umbilical cord and allow approximately 30 seconds to dry.
  • Whilst holding the umbilical cord to dry, using sterile scissors cut a length of 15-30cm of umbilical cord
  • Repeat the decontamination procedure on the umbilical cord section
  • Clamp the cord at both ends with the sterile clamps provided
  • Insert the cut length of umbilical cord in the sterile container (beaker) provided
  • Fill the beaker with sterile 0.9%NaCl sterile solution to cover the cord and cup tightly
  • Affix the barcode label provided on the container to ensure traceability.
  • Place the container in the cord blood compartment of the Life-Kit

 

BRIEF INSTRUCTIONS FOR CORD BLOOD AND TISSUE COLLECTION

  1. Disinfect / sterilize/ decontaminate the umbilical cord at the puncture site.
  2. Collect as much cord blood as possible.
  3. Mix blood bag contents well during the flow of blood to avoid the formation of clots.
  4. Close all blue clamps once collection is completed.
  5. Replace the needle covers and seal by pulling the blue covers over the needles.
  6. Adhere the Life-Kit tracking code labels (found in the zip-lock bag) on the collection bag
  7. Place the collection bag into the provided zip-lock bag.
  8. Wipe clean Umbilical Cord
  9. Disinfect / sterilize/ decontaminate the cord using sterile gauze soaked in 70% ethanol and allow to dry
  10. Cut a length of the cord
  11. Repeat decontamination by wiping
  12. Place the clamps at both ends of the cord
  13. Insert into sterile beaker
  14. Add saline solution and cup tightly
  15. Label container and pack in life-Kit
  16. Maternal blood: Ensure that blood sample from mother has been collected

If you have any further questions about the cord blood collection procedure, please contact Lifeline

The cord blood sample must be kept at Room Temperature.

Do not place sample in the refrigerator.