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Analysis

Position statement No. 1: Commercial umbilical cord blood collection

1 July, 2008

Position statement No. 1: Commercial umbilical cord blood collection

Medically indicated umbilical cord blood collection is done for infants whose mothers are rhesus negative for a known haemoglobinopathy, such as sickle cell disease or thalassaemia, or for research.

 

Midwives magazine: December 2002

 

Definitions

 

Medically indicated umbilical cord blood collection is done for infants whose mothers are rhesus negative for a known haemoglobinopathy, such as sickle cell disease or thalassaemia, or for research.

 

Cord blood collection may also be recommended for infants when there is a familial history of genetic disorder, which may be treated by stem cell transplantation if the child develops the disease. Stem cells from infants can also be used to treat acute lymphoblastic leukaemia in affected siblings. Altruistic umbilical cord blood donation is managed by the National Blood Service, which holds a registry of donors and possible matches in three UK centres.

 

When stem cell collection is medically indicated, the appropriate cord blood bank can arrange for counselling and collection. Altruistic donation of umbilical cord blood is subject to informed consent, and donors are required to undergo tissue typing and screening for hepatitis B and HIV. Commercial umbilical cord blood collection refers to a service offered by for-profit companies to harvest and store stem cells for a family, even though there is no known medical indication. It is promoted as ‘insurance’ against any future health problems that children may develop.

 

The service costs up to £800 and requires NHS midwives (or other providers) to collect umbilical cord blood in the third stage of labour, which is later sent to the company for harvesting and storage of stem cells.

 

The RCM position

 

The RCM does not support the commercial collection of umbilical cord blood for stem cell harvesting. Further, the RCM believes that the current research evidence has not demonstrated that there is any value to be gained from the routine harvesting and storage of stem cells on demand and that further research is needed in this area. The RCM supports the collection of umbilical cord blood if medically indicated and for research purposes only.

 

RCM recommendations

 

All midwives should be aware of the evidence and issues around stem cell harvesting so that they can discuss this with women and their partners as appropriate. NHS Trusts, in cooperation with heads of midwifery services and supervisors of midwives, should develop a policy which explicitly states that midwives:

 

  • Are not obliged to collect commercial cord blood samples

  • Will not be held responsible for the quality or quantity of the sample collected or for transportation and storage difficulties if they choose to assist the woman. Maternity services should develop methods (in consultation with geneticists, neonatologists and obstetricians) to offer users unbiased, evidencebased information on the indications for collecting cord blood.

 


 

 

Additional information

 

Additional information is available in the RCM guidance paper 1a: Commercial umbilical cord collection.   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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