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Abstract SUMMARY Aim of the study The purpose of this study is to clarify the impact of technique of umbilical cord blood collection on amount and bacterial contamination of the collected blood. Methodology The present study was conducted on a random cohort of 120 deliveries at Maternity Hospital, Ain Shams University and Ghamra Military Hospital. UCB samples were collected after placental delivery (exutero). The samples were divided into 2 groups according to the method of UCB collection: • Group 1 60 UCB samples were collected by blood bag method , 14 samples were discarded due to incomplete procedures, clotting of the blood or any exclusion criteria, so 46 samples were included in this group. • Group 2 60 UCB samples were collected by syringe method , 6 samples were discarded due to clotting of blood or any exclusion criteria, so 54samples were included in this group. Summary 121 Inclusion criteria: All deliveries will be included as long as consent was taken from parents for cord blood collection. Exclusion criteria: The cord blood will not be collected if there is: • Maternal history of jaundice. • Maternal hepatitis or infectious diseases. • Maternal inherited blood diseases. The cord blood will be discarded if: • Any Congenital anomalies. • Chromosomal disorders. • Suspected inborn errors of metabolism. Comprehensive history taking was done for all stressing on: Pre-existing maternal problems; Fetal problem: and Natal and Postnatal history. Detailed clinical neonatal examination :Determination of the gestational age using Ballard score , APGAR score at 1 & 5 minutes, Determination of birth weight, length and occipito - frontal circumference and Cord and Placental examination and weight and Neonatal examination. Summary 122 Results This cross sectional study included 100 newborns:48 (48%) were males and 62 (62%) were females, with GA of 36.290±3.453weeks ranged between , birth weight 2912.33±767.705gm, length 47.740±3.828 cm and OFC was 33.990±2.129cm. The placental weight was 644.14±151.361 gm and ranged between 284 to 1250, and cord length was 56.20±11.70 cm and ranged between 19 to 133. The APGAR score at 1 min ranged between 4-10 with median 7, while at 5 min it ranged between 7-10 with median 9. Maternal age ranged between 25 to 32 with mean±SD 27.37±1.48 years, weight was 77.91±3.92 Kg and ranged between 70 to 87and parity ranges between 1 to 6 with median 3,mother Hb% ranged between 11-13.5 % with mean±SD of 12.10±0.77 Twenty seven neonates were delivered by NVD(27%) and 73 with CS (73%) , 28 deliveries with general anesthesia(28%) , 45 with spinal anesthesia(45%) and 27 with no anesthesia(27%). Cord blood samples collected with bags were 46 samples (46%) and with syringe 54 samples (54%). Regarding maternal factors, 11 (11%) mothers had hypertension while only 7 (7%) had preeclampsia, 10 (10%) had gestational DM and all of them did not have fever during that pregnancy. Summary 123 The amount of collected blood is positively correlated with gestational age, neonatal weight, neonatal length, OFC (r=0.434, p<0.001) and placental weight There was no correlation detected between maternal age, weight, Hb or APGAR score with the amount of collected blood. There was statistically significant higher amount of blood and lower time of collection in Bag group compared to Syringe group The amount of collected blood was positively correlated with TNC (r=0.699, p=0.003) and negatively correlated to RBCs count (r= -0.253, p= 0.014) and HCT (r=-0.258, p=0.012) values. Positive bacterial culture occurred significantly more in the NVD group (44.44%) compared to the CS group (9.59%) , more in syringe method (22.22% compared to bag method (15.21%) by Fisher exact test (p=0.04 & 0.05 , respectively). Non-statistically significant difference between studied groups regarding culture results in day one or day seven was detected. There was statistically significant lower TNC, TLC, Lymphocytes, monocyles, esinophils, granulocytes, RDW and PDW in Bag group compared to Syringe group. Non-significant difference between both groups regarding the rest of CBC parameters was detected. Summary 124 The logistic regression showing that after elimination of all other factors, there was highly statistically significant association between higher amount of collected cord blood and GA, mode of delivery, maternal preeclampsia, TNC and TLC and a statistically significant association between higher amount of collected cord blood and maternal weight, placental weight and maternal hypertension. The logistic regression showing that after elimination of all other factors, there was highly statistically significant association between positive culture of collected cord blood and GA and mode of delivery and a statistically significant association between positive culture of collected cord blood and maternal preeclampsia, TNC and TLC. |