Placing the newborn on the maternal abdomen after delivery increases the volume and CD34⁺ cell content in the umbilical cord blood collected: An old maneuver with new applications

OBJECTIVE: Our purpose was to increase the number of the progenitor cells in umbilical cord blood collected for transplantation. STUDY DESIGN: We randomly assessed the effect of 'upper' and 'lower' positions of the newborn on the volume and progenitor cell (CD34⁺) content of the umbilical cord blood collected from 49 healthy, vaginally delivered, term neonates. RESULTS: Twenty-two collections were performed in the 'upper' and 27 in the 'lower' position. The volume of umbilical cord blood obtained in the 'upper' position was 108.1±19.1 mL compared with 42.6±19.5 mL in the 'lower' position' (P < .0001). Mononuclear cell separation revealed significantly higher numbers of cells in umbilical cord blood obtained in the 'upper' group (P < .01). Although the percentage of CD34⁺ cells was comparable, the absolute number of CD34⁺ cells was significantly higher in the 'upper' group because of the larger volume collected (P < .02). At 24 hours after delivery the hemoglobin levels were not significantly different between newborns of the 2 groups. CONCLUSIONS: Placing the newborn on the maternal abdomen after delivery and before cord clamping may significantly increase the volume of umbilical cord blood collected and therefore the CD34⁺ counts that improve transplantation success without placing the mother or the newborn at risk.