gabriela, picunurse and others, I’m looking at you! And yes, this question is the reason I re-upped.
The most recent thread that touches on the (thankfully, as I’ve been in dicussions with partial-stakeholders in my children’s health about this) wondrus workings that are the placental and cord system for infants has been quite helpful. But my question is going a little further.
Y’all or someone all stated that the placenta is made up both of maternal and fetal tissue; which has been confirmed by a news report I’d read about examination of the placenta post-birth for certain things (and earlier reports I’d had from acquaintences of professional examination of their placenta post-delivery for various medical reasons that they were aware of at the time of pregnancy).
I’ve never been a big fan of paying to save my kid’s cord blood specifically for my kids (besides the AAP reccs backing me up, there isn’t enough out there in our combined family medical history to consider us any more likely to need it than anyone else). However, with the larger number of studies being run on placentas and follow ups on the children’s health, and new things “being discovered every day” (to sound like a private cord bank brochure a moment) would preserving the cord blood maintain any more or less information than just (somehow) preserving the entire placenta for later use and examination?
If not, how would one possibly preserve the placenta in a state that it could be examined months or years later? I’ve searched a bit but not found any company that provides that service, but if I could get my hands on some canning jars and formaldahyde … possible? Though it’s too late for my first child to have his placenta stored by us or someone else, for our next child we’re not likely to have a hosptial birth, and would be able to prep and have available (if I knew how) something to preserve the placenta in a study-viable way (Yes, I read Driving Mr. Albert more than a few times, why do you ask?).
Mynn, I am sorry; I’ve been away on a business trip, and in lurker mode ever since.
Preserving placentas in formalin is done all the time. Since as a general business problems with placentas are diffuse (all throughout the placenta) rather than focal (in one spot), the protocol is to preserve just a couple of little characteristic pieces, one from the edge and one from the middle. If there are any focal lesions (problems in just one spot - lke this one then we will take an additional piece from the area of the problem. In that picture, incidentally, you are looking at a slice of a placenta, which has been preserved in formalin. The big white spot is the infarct. It’s white because the normal healthy placental tissue has been replaced by scar tissue.
That’s an interesting site if you want to look at too many scary pictures, by the way.
Were you talking about preserving cord blood with its cells alive, or preserving cord blood as a dried spot on a DNA card? Obviously, if you are thinking about fixing a disease like leukemia in your child or another child several years from now, dropping a placenta into formaliin won’t work. Formalin kills everything it touches. It’s more vicious on bacteria and viruses than bleach or acid. The reason we don’t use it as a surgical wipedown is because it also kills human cells.
I had an anatomy teacher about three decades ago who intentionally removed his rubber gloves now and again to touch the preserved organs with his naked hands. He knew there was no germ danger, and being the sick introspective reclusive nerd he was (sir, if you’re on these boards, I apologize), he said he liked the feeling of deadening he got as the skin on his thumbtip and fingertips went dead. Like he was wearing an invisible layer of plastic that always kept him separated from the world. Of course, if he stopped doing it for a month or so, the dead layer wore off as new live skin cells pushed their way up from the basal layer, and he got his sensation of touch back. Good for him; dead skin doesn’t last forever. If you put a placenta into formaldehyde, you’re not going to have any live cells coming back. The whole thing will be dead, preserved emotionless and frozen in time, and will basically never rot but never live. Zombie Placenta!!! (rock band)
The big difference between preserving cord blood as a dried spot on a DNA card and preserving live cells is you cannot use the dried spot to reconstitute a bone marrow full of leukemia. You’d need live cells for that. Cord blood is particularly good for it because it’s full of stem cells. Because there are so many stem cells in cord blood, people are also talking about using them to heal commoner diseases that may take decades to show up. Some of that is fantasy and speculation right now. But if the cord blood stem cells are still good thirty or fifty years from now - and I don’t know if they can do that - KarlGauss? Antigen? Anyone know? - you might be doing your kid a really big favor.
The big difference between preserving cord blood as a dried spot on a DNA card and preserving the placenta in formalin is you cannot do DNA on formalinized tissue. Oh, sometimes you can, but it’s not good. Formalin is the enemy of DNA. Whereas simple drying preserves DNA, and you can still go FISHing in the dried blood on a blood spot card for rare gene problems or pre-cancer vulnerabilities.(Inside joke: FISH stands for Fluorescent In Situ Hybridization - ask Antigen for further explanation.)
When you drop the placental slices in formalin, it’s as if you injected them with plastic. Everything is perfectly preserved to be inspected under the microscope by the eyeball, but you can no longer reach into the DNA and unfurl it, or bring anything to life from it. All dead.
Wow. You rock. Hope you had a good trip. Sorry if I made it seem as if this were any sort of calling you out. I’ve been in lurker mode a long time, but noticed your recent joining and do enjoy reading you and your colleagues’ posts. [/fangirl gushing]
Actually, my weird question came up for a couple of reasons - one, we’re looking at saving the cord blood versus simply letting it eke into the child until it’s done (stops pulsing), and trying to decide if in general it is worth the cost. At this point, if you are from a family without a large number of known problems or without a specifc thing to be aware of that are already or very close to being “helped” or cured by cord-blood cells, it doesn’t feel (at least to me) like a good use of resources.
If we were closer to a facility that accepted both cord blood donation and me (I’ve spent a couple of years trying to find medical people willing to legally/insurance coverably through my next child birthing) we’d consider trying to capture some cord blood for general use, donation, and study.
But this popular summary and the study’s abstract made me wonder if persuing a means of preserving this placenta, formally or informally, for later study, might be of some use to us or others later on.
Most women in my position who choose to give birth at home or birthing center or other non-medical facility generally have the staff preserve the placenta in a freezer box or bag if it is not disposed of as medical waste. These women generally plant it later outdoors or even consume it.
Assuming we can’t get our hands on formalin and the necessary preservation materials (either for the entire organ or bits) as ‘civilians’, can it be frozen until/if we can gain hold of these materials, or find a company who can preserve it in observable format for later study, if not for something along the lines of the autism study above, but other research?
I know preservation is done (has been done for folks I know with known issues) … I guess I’d have to look more towards temporary preservation until I can secure agreement from a company to do such a user-requested preservation. Or would freezing it pretty much negate any future chemical preservation usefullness (by the freezing process destroying some of the structure we want to preserve, for example).
All this does bring to light our consideration for storing cord blood - if not for whipping up a stem-cell shake on the off chance we need it, then perhaps if it allows us to have a bit of a “before” snapshot of our child genetically, et cetera in case of any sort of “after” (though even that seems a bit far fetched - not much we do that would cause us to change dramatically from birth and beyond … I guess cord banks could be of use to an ultra-facist dictatorship, seizing the samples and using them in some scary future police state to track down Enemies Of The State).
Thanks, and have a good weekend if I don’t stop back in this afternoon.
I didn’t realize there was a difference, or option! Wow. I’d love to “card my kid”, would have done it to the other kid if I’d known it was an option. I suppose I knew it was, given that the big thing in “child ID” is scraping off some DNA to save.
But yeah, we’d been talking about the freezer case donation where you clamp the cord ASAP at birth and drip it all into a tube, rather than let the circulation changes complete on their own. Not a full lotus birth or anything, but squeezing in those last few drops.
Most of the places I’ve glanced at (wasn’t a big fan of the idea, ever) seem to all state that they’ll only store it for 18 years, assuming all goes and stays well with their facility. I’ve seen impressive lists of what can/probably can be done, but not many of our familial ailments seem to be on that list at this point; seems speculative to go out for such unlikely-use insurance for ourselves at this time.
I haven’t tried freezing placentas. If you get them down below -70 (which usually takes a scientific freezer) you can keep them for many years without any rot setting in. (I learned this on the Straight Dope, incidentally, but it explained to me why our specimen freezer at work is -70.) When you unfreeze them and section them and stain them, there will be some artifact from the ice crystals, but any decent pathologist ought still to be able to read the slides.
This is what I would do with a placenta. Start with it intact on a clean board covered by a cloth. Have water nearby with a sprayer head. Have a camera, a clean scissors (dip it in the formalin), a clean long sharp knife, a scale that weighs in grams, a measuring tape (ideally in cm), and rubber gloves. Have a half gallon of 10% formalin in a plastic bucket with a top that seals. Assistant nearby writing things down.
Put on the rubber gloves.
Find the rupture point of the membranes (they will look like a circular veil; the opening where the bride puts her head in is the rupture point). Wash the blood off with plain water and photograph the membranes. They should be glistening and transparent without any green or yellow opaqueness. Take a knife and cut a rectangle of membranes from the rupture point to the edge of the placenta. Roll it up and throw it in the bucket.
Cut the membranes off at the edge of the placenta with the scissors. Either discard them, or wash them off and toss them in the bucket. (Free blood combines with formalin, and inactivates it. A dense red formalin fluid almost guarantees bad preservation.) Photograph the placenta from the fetal side (umbilical cord) and the maternal side (blood clots). Peel the clots off the maternal side, weigh them, have your assistant write down the weight. Wash off the maternal side and photograph again.
Check where the cord goes in: 1) in the middle 2) not in the middle, off to one side, but not at the edge 3) at the edge 4) doesn’t even reach the edge - in the membranes. 1) and 2) are both normal, with 2) the commonest by far. 3) isn’t good, and 4) is bad. Measure the length of the cord. If you only have an inch measuring tape, multiply the results by 2.54. Assistant writes it down.
Cut the cord off the placenta. Cut it up into little bits (not all of it; cut it eight or ten times and cut a little bit off each segment end). It is remarkably hard to cut a level round off the end of the cord, because it wiggles and because it is spiraled. Throw the little bits into the formalin bucket.
Weight the placenta and have your assistant write its weight down. Measure its length by width by thickness and write those down. Record the birthweight of the baby next to the placenta weight (the ratio of the two is important - the placenta should weigh just about a seventh of what the baby weighs; more or less means sicknesses).
Slice the placenta up from one edge to the other, all the way through, in slices no thicker than your little finger. Turn them on their sides and photograph them, far away and close up. Any areas that look different, pay special attention to those; the whole thing should be as homogenous as a steak.
Wash the slices well to get as much blood out of them as you can. Throw slices into the bucket until its formalin starts to turn a faint red. Make sure you get one slice from where the cord went in, and another slice from the edge, any slice from an area that looked weird, and as many more slices as you can put in without using up the formalin.
Seal the bucket and throw away the rubber gloves. Bury the rest under a tree or in the garden as you please.
Put the formalin bucket into a thick plastic bag (to prevent slow loss of liquid) and put it someplace safe high up where no child will get into it. Check it once a year; add more formalin as the level declines. If you ever need it examined by a pathologist, a record of what you did, plus the photographs, plus the weights and measures, should be more than adequate.
Aw, thanks for thinking of me, gabriela. Incidentally, your posts rock. And if I ever need a band name, I’m coming to you first.
To be very honest, I’m not sure how long cord stem cells are good for, when properly stored. When someone has a rare blood type (I mean really rare, not like AB neg) they can store their own cells, frozen in glycerol, for up to ten years in case they ever need a transfusion, since a matching donor will be almost impossible to find. Those are red blood cells, though, whose only job is to serve as baggies for hemoglobin and therefore oxygen transport. If we’re talking about stem cells, they need their DNA and cellular structures to stay intact, because they’re going to have to multiply and mature.
The storage of cord blood is mainly done in order to have a stockpile of stem cells for use in transplant/transfusion if your child develops a childhood leukemia. His/her white cells aren’t acting properly, so they kill some off and then transfuse the stored ones in hopes that they’ll take over and fix things. I’ve always been under the impression that the stem cells were mostly for the 7 or 8-year-old who gets leukemia, and not for the 30-year-old who does. But like **gabriela **said, if they can teach those stem cells to be something other than blood cells, and can do it after 30 years of -70C storage, then we’re onto something pretty awesome. How far are we towards that? I’m not up on the research, but I can ask around.
I will look into stem cell storage for you as soon as I can. I know we’re doing autologous stem cell transplants (autologous meaning giving back the person’s own cells) at my hospital, but only one person in the lab is trained to work on that stuff, and it’s not me! I’m working nights this week, but as soon as I have a day shift, I’ll ask that person, or the hematologist, what it’s all about.
We rolled them up on a wooden stick, making placenta membrane lollipops to toss into the formalin. Good times. Then when we’d take them out, we’d slice them up like little jelly rolls to smoosh into the processor cassettes. God, I loved my pathology internship. Why am I in a blood bank??
I’ve managed to educate myself on the auto-stem-cell procedures being done at my hospital. They’re for patients with leukemia.
They give the patient injections of a colony-stimulating factor, which tells stem cells in the bone marrow to multiply like mad. They spill out into the blood, and blood is taken from the patient and treated to harvest these cells. The cells are frozen in liquid nitrogen and stored.
After chemotherapy has killed off most of the patient’s cells, the frozen stem cells are thawed and transfused back in.
So even if cord blood isn’t really viable after a few frozen years, there are still other options available.
Thanks to you both, very much. Yucky lunchtime reading, but fun. (Yeah, I’m a wimp who uses gloves to handle raw meat at times.)
Considering our three baby-sitter options bailed on us for tonight and I’m having enough troubles getting someone to help us with photography when the Big Day arrives, I have a feeling the home-preservation route isn’t going to fly for us.
I figured I’d find out I couldn’t do it, then end up deciding to definitely store cord blood, but I still haven’t found a compelling reason to shell out or have shelled out $300 or so a year … the few things we do have that “run” are not necessarily stem-treatable, or severely untreatable by conventional methods; assuming, like ‘wedding dress preservation’ that you don’t know what you’ve got until or unless you pop the seal.
[/fangirl gushing]
Thanks again.