The string of life or the Umbilical cord is the gift of love and care during pregnancy from mother to the growing baby and vice versa.1 It establishes the physical and emotional bridge between the mother and the developing baby inside the womb. But, this string of life should be clamped within 1-3 minutes of birth. Wondering why? Let’s know here but before delving into the topic of delayed cord clamping, it is important to understand the concept of the umbilical cord.
Umbilical Cord is a collection of blood vessels which develops in the early pregnancy. It plays a crucial role in carrying the deoxygenated CO2 enriched blood away from the baby in womb to the placenta (an organ developed in the uterus during pregnancy to nourish the growing baby).1 It is also responsible for transferring oxygen and essential nutrients from the mother's blood to the baby.1
Did you know the umbilical cord is clamped and separated from the placenta during the third stage of labor? In this article we will unfold the mystery of optimal timing of umbilical cord clamping after delivery and why it is a controversial topic worldwide over centuries. But, before moving ahead, let us first understand what is early and late/delayed cord clamping.
The World Health Organisation defines ‘delayed cord clamping’ as the clamping of umbilical cord within 1 to 3 minutes of birth or clamping when the pulsation of cords are stopped.2 Let us further understand the reasons why delayed cord clamping is beneficial and how it helps a newborn baby.
Delayed cord clamping is safe, effective and feasible practice for both preterm and term babies. Several studies have confirmed the benefits of delayed cord clamping as described below.
Although delayed cord clamping has a plethora of benefits for the newborn and is promoted as the best practice by healthcare professionals, still there are a few theoretical barriers which need attention. Let us learn about them here.
Thus, it is crucial to understand and follow the guidelines and recommendations for delayed cord clamping to ensure safe practice. Let's learn about them in the following section.
The World Health Organization (WHO) recommends following these guidelines for delayed cord clamping when reviving an unconscious or seemingly lifeless newborn.
In 2017, the American College of Obstetricians and Gynecologists (ACOG) recommended delayed umbilical cord clamping in term and preterm newborns for at least 30–60 seconds after birth.5
The SOGC (Society of Obstetricians and Gynaecologists of Canada) also recommends delayed cord clamping in the following cases.
The umbilical cord possesses extremely precious stem cells which are valuable for the newborn in reducing the effect and combating more than 90 deadly diseases. These include blood cancer, lymphoma, sickle cell anemia, and some immune and metabolic disorders. 7
Studies have shown that delaying cord clamping for 180 seconds can increase blood volume by an additional 75 mL. This blood is estimated to contain between 1,100-45,000 hematopoietic stem cells 8 , which are versatile stem cells capable of developing into various types of blood cells, including red and white blood cells, as well as platelets.9 Thus, expecting parents who are planning to opt for delayed cord clamping and banking their newborn’s stem cells must look out for the best processing method to ensure high efficiency with less volume of cord blood. Let us have a look at the recommended methodology in the following section.
The processing method has a large impact on the quality of stem cell collection after delayed cord clamping, which can ultimately lead to a different outcome if it is used in transplantation. The processing method should allow a higher number of Total Nucleated Cells (TNC) and CD34+ cells (the hematopoietic stem cells) after the cord blood processing to increase chances of successful engraftment.10 Thus, parents planning to combine both delayed cord clamping and umbilical cord blood collection should opt for Pentastarch processing.
In a study published in the International Journal of stem cells, it was found that Pentastarch processing is the most flexible and the only processing method type which is unaffected by volume of the cord blood.11 It is a US FDA 510K approved processing system manufactured under US FDA's current Good Manufacturing Practices (cGMP). Compared to other methods, Pentastarch processing enables better recovery and higher yield of viable CD34+ progenitor cells and TNC from even a small volume of cord blood.12
LifeCell is the only cord blood bank that uses the most advanced Pentastarch cord blood processing technology in India for stem cell banking. It allows higher stem cell recovery, improves the outcome of stem cell transplant and saves your money by reducing the post transplant recovery time to just 16 days which is the fastest compared to other processing technologies.