Healthcare profession FAQ

When should expectant mothers think about cord blood collection?
What level of knowledge do I need to discuss this with expectant mothers?
If a mother wishes to proceed with Cells4Life cord blood storage, what happens next?
What does the collection kit contain?
What happens when the mother goes into labour?
At what stage should the cord blood be collected?
What if we prefer to take the cord blood in utero?
Is there a difference in blood volume in collecting blood ex utero compared to in utero?
What if the mother prefers to have a physiological third stage of labour?
How does caesarean section affect the collection process?
What if we are only able to obtain a small amount of blood?
What happens if there are complications during the delivery?
What happens after the blood is collected?
How quickly is the blood collected and processed?
What testing do you perform on the blood?
Is there regulation of cord blood storage in the UK?

When should expectant mothers think about cord blood collection?

In order to make an informed decision, each mother should have information made available at their booking appointment. This allows them the choice to consider and research umbilical cord blood storage, and include it as part of their birth plan should they choose. It is however possible to arrange this service at very short notice, assuming that the couriers can reach the hospital prior to the birth happening.

What level of knowledge do I need to discuss this with expectant mothers?

This depends on your level of interest. Knowledge of your hospitals policy relating to this, what is actually involved, and the practical aspects of when it is not possible (nuchal cord, maternal haemorrhage etc) can be helpful.

Training and information can be provided on request, however you only need to provide the parents with our booklet which contains our contact details. All women who express an interest in cord blood storage have the opportunity to discuss all aspects of the service fully with trained support specialists, doctors and health professionals.

If a mother wishes to proceed with Cells4Life cord blood storage, what happens next?

A welcome pack is sent to the mother which contains detailed information, and Cells4Life umbilical cord blood storage agreement. After full information has been provided mothers (and fathers) are asked to carefully read and sign a Cells4Life cord blood storage agreement if they wish to go ahead with cord blood collection.

All mothers are requested to inform their midwife or obstetrician as soon as possible of their intention to store their child’s cord blood. Upon receipt of a signed Cells4Life cord blood storage agreement and payment a collection kit is sent by Special Next day delivery to the mother’s home address.

Courier service is also available at an additional cost.

What does the collection kit contain?

The Cells4Life cord blood collection kit contains the following equipment:

• Main Umbilical Cord Blood collection bag with needle attachment and a spare
• Gauze swabs
• Iodine swab-sticks
• Cord Clamp
• Biological Sample packaging
• Maternal blood sample collection

A photographic step-by-step collection guide containing details of the Cells4Life 24hr automated collection line is also contained within the kit.

What happens when the mother goes into labour?

Mothers are instructed to bring the Cells4life collection kit with them to the hospital, if for any reason the kit is lost or forgotten we will endeavour to courier a new kit to the mother at short notice, at their cost. The Cells4Life umbilical cord blood collection protocol, contained within the kit, sets out how the blood should be collected and provides a guide for the midwife or obstetrician to follow.

At what stage should the cord blood be collected?

We recommend that the cord blood is collected after the 3rd stage of labour, following the cord being clamped and the placenta being delivered.

At Cells4Life we feel that collecting the blood at this stage interferes less with the birthing process and this is a guideline adopted by the RCOG in their Position Paper 2. 

There is also evidence to show that contamination rates are lower.

What if we prefer to take the cord blood in utero?

Cells4Life have adopted a policy of suggesting collection after the 3rd stage of labour, however, this is only a suggestion and we are happy for you to collect the blood in utero if this is your preference.

Is there a difference in blood volume in collecting blood ex utero compared to in utero?

A study has shown that there may be slightly higher blood volumes taken when the blood is collected in utero, however there was no significant difference in the stem cell counts of the blood that was taken from either method. The over-riding factors are the timing of this and the midwife’s priorities for newborn and mother’s care e.g. time to skin-to-skin contact, maternal haemorrhage etc. 

What if the mother prefers to have a physiological third stage of labour?

There is no evidence to suggest that this would affect cord blood collection. At Cells4Life we would suggest that following natural delivery of the placenta and cutting of the cord that the cord blood is collected as soon as possible.  This is because the natural clotting process will reduce the amount of blood available for collection. 

How does caesarean section affect the collection process?

The collection process proceeds essentially the same way with a caesarean section as it would in a natural birth.

What if we are only able to obtain a small amount of blood?

There may be situations where only a small volume of blood can be taken from the cord. Even though current studies have shown that as little as 30mls of blood typically contains enough stem cells to be of therapeutic use for transplant it may be possible with future amplification technology to therapeutically use smaller volumes. We do ask you to send us all samples regardless of volume for our assessment.

What happens if there are complications during the delivery?

At Cells4Life we feel that the midwife’s responsibility is to the mother and baby. We do not want cord blood collection to in any way distract from this. If there are complications there may be situations where it is unsafe to take the cord blood and we leave this entirely at your discretion.

This is clearly stated in the contract the parents sign and they are made aware of the possibility of collection not being possible when discussing the service with our staff.

Can I be held liable if I do not collect the cord blood for any reason?

Within the Cells4Life cord blood collection agreement it clearly stipulates that:

“You understand that there are risks with any medical procedure, that there may be additional considerations or unforeseeable circumstances during the delivery of your Child and which may affect the collection of Cord Blood. The safety and care of the Child and mother are of primary concern. You therefore acknowledge and agree that the qualified medical professional may, for any reason and at their discretion, refuse to collect the Cord Blood. This is not something within the control of Cells4Life. In such circumstances, please notify us and this Agreement will be cancelled and we will reimburse all of the fees already paid by you to us as detailed in the Schedule”.

What happens after the blood is collected?

Once the blood has been collected the mother (or father) is asked to sign the label to confirm that it is their baby's blood. Once the blood is packaged correctly as shown in the protocol then the mother/partner is asked to telephone the 24hour Cells4Life cord blood collection line to arrange collection by our dedicated medical courier. We recommend the mother keeps the kit with her as the courier will ask for her by name and collect the kit personally upon arrival at the hospital. The kit should be kept at an ambient room temperature until the courier arrives.

How quickly is the blood collected and processed?

It is critical that samples are handled, delivered and processed by trained individuals. Studies have shown that after 24 hours sample quality may deteriorate. At Cells4Life we aim to process the sample within 12-24hours of collection and this is viable as our storage facility is based within the UK and we use medical couriers 24 hours a day, 365 days per year.

What testing do you perform on the blood?

At Cells4Life the maternal blood is tested in accordance with Department of Health guidelines, 30 days before and 7 days after delivery. A maternal blood testing kit is sent out with the cord blood collection kit and contains all the necessary equipment to collect the maternal blood. We then send on the blood to a CPA accredited pathology lab for testing. Viability testing is performed before freezing process. Viability results are sent to mothers the following working day from date of birth. Full testing results and a test certificate are sent to the mother.

Is there regulation of cord blood storage in the UK?

Both the MHRA (Medicines and Health Regulatory Agency) and HTA (Human Tissue Authority) in the UK enforce the EC Human Cells and Tissue Directive. 

In 2004 all laboratories were able to apply for accreditation from the MHRA to ensure compliance with ISO 9000 standards, good clinical, manufacturing and laboratory practices. 

By the end of 2006 all laboratories that store human cells and tissues must be licensed by the HTA. 

Cells4Life Ltd has both MHRA accreditation and HTA licenses

Cells4Life is also registered with Data Protection.