Two venipunctures in umbilical cord blood collection: Perception and real use by midwives

Abstract

Introduction The collection of umbilical cord blood (UCB) is a unique moment, it requires trained professionals with skills to execute the technique, to obtain the maximum blood and an adequate cellular recovery. In this way, the Portuguese public bank developed a standard operating procedure and disseminated for the execution of the UCB collection technique, to maximize the volume and to minimize the 70% discarded rate. The established technique is performed after birth with the placenta in utero and consists in obtaining by gravity the blood that remains in the placenta and the umbilical cord, through the execution of two distinct punctures in the umbilical vein (one most distal and other in the proximal region of the placenta). Objective This study aims to identify the perception that midwives have about the utility of two venipunctures in performing the UCB collection technique and to identify its real use for maximizing blood collected Method The data were obtained through a semi structured interview, carried out to 10 Midwives. The interviews were previously scheduled, voluntary and anonymous participation requested. Data were recorded, transcribed and analysed using a content analysis technique. Results Ten midwives participated in the study, 9 females and 1 male. The experience of the participants in the UCB collection ranged from 2 to 20 years. Concerning the perception of utility, most of the participants do not consider, the execution of 2 venipunctures, useful for obtaining more volume. During interviews it is said that: "There is no need, usually with a puncture is achieved", "a puncture is enough". Regarding the real use of the procedure only 1 participant reported doing, 4 admit being rare, 3 sometimes and 2 never do. In the opinion of the interviewees, the second venipuncture is associated with the contamination of unit and the formation of clots. Conclusion The midwives do not recognize the utility and do not use the second puncture to maximize the volume collected. The results of this investigation recommend a reflection about the accuracy and assessment of the procedure. In practice the collection manager should make a quality improvement of these procedures to minimize the number of discards. Keywords Collection of umbilical corb blood, ,