ArticlePediatric research2026
Umbilical cord milking as a technique to harvest cord blood derived cells for regenerative applications.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUmbilical cord blood (UCB) is increasingly studied for regenerative therapies, yet the impact of different collection techniques on cell yield and quality remains unclear. This study compared standard needle-and-bag UCB collection with manual cord milking, performed both in utero (placenta attached) and ex utero (placenta delivered), using samples from healthy term infants ( > 37 weeks gestation).
methodForty-two samples (n = 10 standard in utero, n = 10 standard ex utero, n = 10 milking in utero, n = 12 milking ex utero) were analyzed for blood volume, mononuclear cell count, and cellular composition via flow cytometry. Key cell populations included hematopoietic stem cells (CD34 + CD45 + ), endothelial progenitor cells (CD45 + CD34 + CD31 - CD133 + ), and mature endothelial cells (CD34 - CD45 - CD31 + ). Plasma cytokines, including inflammatory and angiogenic markers, were also assessed.
resultsNo significant differences were found in total blood volume or mononuclear cell counts across groups. However, endothelial progenitor cell viability was significantly reduced in cord milking ex utero compared to standard in utero collection (p < 0.0001). Cytokine analysis showed elevated IL-1RA and reduced VEGF-A in cord milking ex utero samples (p < 0.0001 and p = 0.0004, respectively).
conclusionThese findings suggest that in utero cord milking may be a viable alternative to standard UCB collection, preserving cell viability and cytokine integrity. IMPACT: The standard method for collecting umbilical cord blood (UCB) has limitations, especially in cases like premature birth, where low volumes yield insufficient mononuclear and hematopoietic stem cells for therapeutic use. This study evaluated an alternative technique-umbilical cord milking-against the standard approach. As the first study to assess its efficacy for UCB collection, the findings offer insights into a viable alternative method.
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