Umbilical cord blood banking options and the prenatal patient: an obstetrician's perspective.

successful cure of the hematological manifestations of Fanconi’s anemia (4), thousands of people worldwide have been beneficiaries of these therapeutic advantages, and to date, nearly 500 umbilical cord blood hematopoietic stem cell transplants occur annually in the United States (5). The vast majority of these hematopoietic transplants occur using publicly banked umbilical cord blood, some utilize cord blood from a relative; typically a newborn sibling, and a few are autologous cord blood transplants. Other less differentiated populations of cord blood stem cells also exist and may have exciting future clinical implications (6–9). Obstetricians and nurse midwives deliver more than 4 million babies each year in the United States (10). As such there is for all intents and purposes, a practically limitless quantity of umbilical cord blood stem cells passing through the hands of obstetrical care providers; yet the phenomenal progress in the utilization of umbilical cord blood stem cells to treat more than 75 different malignant and nonmalignant conditions (11,12) has for the most part, escaped the “obstetrical radar.” As the scientific reports of these advances have primarily (and appropriately) been reported in the hematological, oncological, cellular research, and transplantation biology literature, the physicians who find themselves literally “holding the cord,” also find themselves subject to receiving most of their education on this subject from the marketers of private umbilical cord blood banking and patients themselves, as it relates to the “obstetrical option” of umbilical cord blood banking. Introduction