This RCT compared ex-utero (after placental delivery) vs. in-utero (before placental delivery) umbilical cord blood (UCB) collection in 101 analyzed births (53 in-utero, 48 ex-utero) at a single Spanish center from September 2023 to September 2024, with a 1-min delayed cord clamping protocol in both arms.
Ex-utero collection was non-inferior to in-utero collection: mean UCB weight was 107.19 g vs. 110.81 g (mean difference −3.62 g; 95% CI −13.41 to 6.16 g). TNC count, RBC count, hematocrit, platelets, and bacterial contamination rates (1 positive culture each) did not differ significantly between groups.
High exclusion rate (28/129 randomized were excluded—18 in the ex-utero arm vs. 10 in the in-utero arm), potentially introducing selection bias. Single-center, unblinded design limits generalizability. Bacteriology was assessed only in units designated for clinical use, not all collected units.
Ex-utero UCB collection after placental delivery is a viable alternative to the standard in-utero method, offering a less intrusive birth experience without sacrificing unit quality or safety. Banks and maternity units can consider standardized ex-utero protocols to encourage more cord blood donations.
