Umbilical Cord Blood Collection During Cesarean Section: Effect on Maternal Blood Loss and Morbidity [ID 2683610

Abstract

INTRODUCTION: Umbilical cord blood collection (UCBC) for stem-cell banking is routinely performed during cesarean sections (CS). Few studies have examined the maternal effect. This study's objective is to evaluate whether UCBC during CS is associated with increased maternal blood loss and morbidity. METHODS: This was a single-center retrospective cohort study of primary CS (PCS) in 2021. Exclusion criteria were age less than 18, multifetal gestation, gestational age less than 34 weeks, emergency, and infection. Data were compared between participants with and without UCBC during PCS. Extensive demographic data was collected and compared. The primary outcome was quantitative blood loss (QBL). Secondary outcomes were operative time, hemorrhage medication usage, and blood transfusion (BT). RESULTS: Eight hundred two PCS were reviewed, and 191 were excluded. Of the remaining 611, UCBC was attempted in 151 (24.7%). The UCBC cohort had higher gestational age (39.1 versus 38.7; P=.007), were less often in labor (P=.004) or on magnesium (P=.022), and were more likely to be scheduled (P=.002). Quantitative blood loss was higher with UCBC (1,091.5 versus 1,007.5 mL; P=.075). In non-labored PCS, the QBL difference was statistically significant (941.8 versus 798 mL; P=.034). Umbilical cord blood collection was associated with increased operative time (62.4 versus 56.8 minutes; P<.001) and postoperative BT (7.2% versus 3.3%; P=.036). There were no associations between UCBC and usage of hemorrhage medications. CONCLUSION: Umbilical cord blood collection increases QBL in nonlabored PCS. Umbilical cord blood collection increases operative time and postoperative BT in PCS. Patients should be appropriately counseled and selected for UCBC based on hemorrhage risk factors.