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Advice against Health Hazards

Why do Obstetricians Still Rush to Clamp the Cord?

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For many years, the World Health Organization and the International Federation of Gynecology and Obstetrics have advised against early umbilical cord clamping. But obstetricians have been reluctant to change their habits.

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Although no clamping occurs in nature, cord clamping has become such an accepted norm that delayed clamping is generally considered a new or unproved intervention.

Basic teaching of physiology could be a factor — most textbooks state or imply that the cord circulation closes only because of the application of the cord clamp, which is not accurate.

Writing in the British Medical Journal, Dr. David Hutchon argues:
“Clamping the functioning umbilical cord at birth is an unproved intervention. Lack of awareness of current evidence, pragmatism, and conflicting guidelines are all preventing change. To prevent further injury to babies we would be better to rush to change.”

A separate review in the Journal of Cellular and Molecular Medicine also highlights the importance of delayed cord clamping, stating:

“Many clinical studies have revealed that the delayed cord clamping elevates blood volume and hemoglobin and prevents anemia in infants.

Moreover, since it was known that umbilical cord blood contains various valuable stem cells such as hematopoietic stem cells, endothelial cell precursors, mesenchymal progenitors and multipotent/pluripotent lineage stem cells, the merit of delayed cord clamping has been magnified.”

Resources:
British Medical Journal November 10 2010
Journal of Cellular and Molecular Medicine March 2010; 14(3):488-95
iVillage.com June 1, 2010

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News on Health & Science

Banking on Stem Cells

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Advertisements in the media advise parents to “plan and protect your children’s future and their health status”. These are not commercials for insurance plans, but private stem cell banking facilities, where, for a steep price, your baby’s umbilical cord stem cells can be preserved for future use.
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Stem cells are in the news. Independent national and international laboratories are making claims and counterclaims about the “miracles” they have achieved with them. Paralysed people have been able to walk, rare degenerative nervous and muscular system diseases been reversed, and some cancers of the blood cells cured. People with terminal illnesses have also been offered hope…..click & see

Actress Lisa Ray underwent stem cell therapy for multiple myeloma, a cancer of the white blood cells...click & see

Stem cells may be embryonic, adult or derived from umbilical cords. Embryonic stem cells are obtained from the extra fertilised eggs at in vitro fertilisation (IVF) centres. The use of these cells is controversial, as, theoretically, they have the potential to become human beings. They are the “spare babies” belonging to a particular IVF couple. When supplied to a stem cell research facility, they are grown in a nutrient broth in a culture dish and used for research or treatment.

Adult stem cells are found in bone marrow. These are harvested from the bone marrow of living donors. It’s a surgical procedure done under anaesthesia with some post-operative discomfort. The cells are capable of eventually forming either various types of blood cells or stromal cells from which cartilage and fat tissues arise.

Haematologists treat a variety of hereditary blood disorders and some of the blood cancers with either autologous (the person’s own) stem cells or compatible donor cells from bone marrow transplants. This technology has been used for the last 30 years. Bone marrow transplants are life saving for people with certain blood cancers. They can also be used for serious blood disorders such as aplastic anaemia. They can also help boost the immune system if it is impaired because of an inherited genetic defect or destroyed by cancer.

Umbilical cords are a rich and non-controversial source of stem cells. Cord blood has a greater ability to generate new blood cells than does bone marrow. Also, smaller quantities of cord blood cells are needed for successful transplantation. These cords are normally discarded along with the placenta from labour wards all over the world.

At present, in India, patients who require stem cell treatment or a bone marrow transplant have to search for a relative who is an appropriate tissue match. Sometimes even close first-degree relatives like a parent or sibling are not compatible. India does not as yet have a centralised national bone marrow registry to match recipients and donors.

Some foresighted countries with efficient national health schemes like the United Kingdom and Brazil do have public cord blood banks. Blood is screened for infective agents, documented in a registry and stored. The chances of finding compatible stem cells are high because of the large volumes stored.

India has private cord blood banks which store blood only for the use of that particular child for a period of 21 years. It may be a cost effective option for parents who have a family history of certain genetic diseases, such as severe hereditary anaemias, immune disorders or certain cancers. Even then, the chance that the blood can be used for that particular child is only 1 in 2,000. In families with no such risk factors, there is only about a 1-in-20,000 chance of the child ever needing a stem cell transplantation. Also, even if the child does require a stem cell transplant, it is unlikely that his or her own cord blood would be the desired source of stem cells. The same chromosomal or genetic defect causing the leukaemia, any other cancer or metabolic disorder, is likely to be present in the child’s stem cell line. There is no proof that a transplant using the child’s own stem cells is effective or even safe, especially in cases of childhood cancers.

Indians have a very diverse genetic make-up. The large-scale collection and storage of cord blood in public banks will be very useful. It can be used for matched unrelated recipients who urgently need blood cell transplants.

Stem cells are probably the future of medicine and the human race. They are multifaceted and have the potential to develop into different cell types. They can theoretically keep dividing as long as the person is alive. When a stem cell divides, each new cell has the potential to either remain a stem cell or become another specialised cell like a muscle cell, red blood cell, or brain cell. This means stem cells can be infused as a sort of emergency repair mechanism to replenish damaged tissues.

Perhaps disease, aging, cancer and even death can be controlled and conquered. And living healthily forever may become a reality.

Source
:The Telegraph (Kolkata, India)

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