Cesarean section due to fetal distress increases the number of stem cells in umbilical cord blood.
BACKGROUND
Umbilical cord blood (UCB) can be used as hematopoietic stem cell source for transplantation. The success of a transplantation is highly correlated with the number of total nucleated cells (TNCs) and CD34+ cells in the UCB. Certain obstetric factors increase the yield of stem cells in the UCB. It is necessary to evaluate optimal conditions in labor to decrease the rate of sample rejection due to low cell count. No data exist regarding the difference between primary and secondary Cesarean sections in terms of efficacy of stem cell harvesting.


METHODS
Seventy-nine consecutive UCB units from women who had a Cesarean section between 1997 and 2003 were included. The number of TNCs, CD34+ cells, colony-forming units (CFUs), white blood cells (WBCs), nucleated red blood cells (NRBCs), and the total collection volume were compared between cases with primary and secondary Cesarean section.


RESULTS
UCB obtained after a Cesarean section due to fetal distress has significantly higher numbers of TNCs, CD34+ cells, NRBCs, and WBCs compared to elective Cesarean section. Of the cases with secondary Cesarean section due to fetal distress, 67 percent resulted in UCB units with sufficient TNC numbers (> or =80 x 10(7) TNCs) compared to 42 percent of the cases with primary Cesarean section.


CONCLUSIONS
Fetal distress increases the number of hematopoietic stem cells mobilized into UCB. Particular effort should be made to collect UCB from newborns who experienced fetal distress.
Manegold
Gwendolin
G
Department of Obstetrics and Gynecology and the Department of Hematology, University Hospital Basel, Basel, Switzerland.
Meyer-Monard
Sandrine
S
Tichelli
Andre
A
Pauli
Doris
D
Holzgreve
Wolfgang
W
Troeger
Carolyn
C
D001772:Blood Cell Count; D001800:Blood Specimen Collection; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D005316:Fetal Distress / Q000097:blood*; D005865:Gestational Age; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies