Cordocentesis

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WHAT IS CORDOCENTESIS? A cordocentesis test, also known as “Percutaneous Umbilical Cord Blood Sampling (PUBS)”, is a prenatal diagnostic test used to determine any abnormalities present in a fetus. During this test, the position of the fetus can be shown on a monitor, using an ultrasound transducer. Then a fetal blood sample is taken from the… Read More

Cordocentesis

WHAT IS CORDOCENTESIS?

A cordocentesis test, also known as “Percutaneous Umbilical Cord Blood Sampling (PUBS)”, is a prenatal diagnostic test used to determine any abnormalities present in a fetus. During this test, the position of the fetus can be shown on a monitor, using an ultrasound transducer. Then a fetal blood sample is taken from the umbilical cord for testing. 

A cordocentesis test is usually done after 18 weeks of pregnancy.

USES OF CORDOCENTESIS

The following are the uses of percutaneous umbilical cord sampling:

  • Detecting infections.
  • Checking fetal chromosomes.
  • Detecting certain genetic disorders.
  • Delivering medications to the fetus.
  • Transfusion of blood to the fetus in the uterus.
  • Detection and treatment of blood conditions like fetal anemia.
  • Cordocentesis can be done when diagnosis can’t be done with other methods like amniocentesis, chorionic villus sampling (CVS), ultrasound, etc.

RISKS OF CORDOCENTESIS

A cordocentesis test carries a risk to both the mother and fetus. The critical risks of percutaneous umbilical cord blood sampling include:

  • Loss of Pregnancy.

The highest risk of percutaneous umbilical cord sampling (PUBS) is the death of the fetus in the uterus. The chance of stillbirth is higher in cordocentesis than in any other prenatal diagnostic tests. About 1─2 out of every 100 pregnancies all witness miscarriage.

  • Fetal Bleeding.

Bleeding from the point of needle insertion attracts serious complications which also become life-threatening.

  • Slowed Fetal Heart Rate.

This sudden slowing down of the heart rate of the fetus may last for a short period, after which it would return to normal.

  • Umbilical Cord Hematoma.

Coagulation of fetal blood within the umbilical cord might occur during or after undergoing PUBS. Most babies don’t develop indications when this occurs. It may lead to a low heart rate.

  • Infections.

A cordocentesis test may lead to a uterine or fetal infection, which may either be deadly or safe.

  • Transfer of Maternal Infections unto the Fetus.

Infections like hepatitis B, hepatitis C, or HIV, from the mother, may as well be passed down to the fetus in the uterus.

  • Fetal-Maternal Bleeding

The blood of the fetus might enter the maternal blood circulation in about 40% of procedures. This problem is more common when the placenta is in front of the uterus.

PREPARATION FOR CORDOCENTESIS

A round of percutaneous umbilical cord blood sampling (cordocentesis) is usually done within the 18th and 25th weeks of pregnancy. 

If you are 23 or more weeks pregnant, try to avoid eating or drinking after midnight on the night before the test (in case of emergency cesarean section). You should try coming with your partner or a friend of yours, who may drive you home after the test. 

After the 23rd week of the pregnancy, cordocentesis is usually done in the hospital, in case the baby develops complications that may require emergency delivery.

A sample of your blood will be taken before the procedure, to enable your doctor to compare it with your baby’s blood sample.

CORDOCENTESIS PROCEDURE (CPT 59012)

Specialist: Obstetrician.

During the Procedure,

  • You’ll be given antibiotics to reduce the risk of a uterine infection.
  • An ultrasound is done to locate where the umbilical cord enters into the placenta.
  • You’ll lie on your back, on an exam table.
  • A special gel would be applied to your stomach.
  • The doctor will use an ultrasound transducer to show your baby’s position on the monitor.
  • He/she would clean your belly.
  • He/she may give you medications to prevent any discomfort.
  • With the use of an ultrasound, the doctor will insert a very thin needle through your abdomen and uterine wall, into the umbilical cord, to remove the blood sample.
  • You need to lie down still when the needle is inserted to remove the blood.
  • You might feel a stinging sensation and cramping in the process.

After the Procedure,

  • The doctor will use an ultrasound to check your baby’s heart rate, after the procedure. 
  • He/she (instead of an ultrasound) may use an external labor monitor.
  • The blood sample obtained will be sent to the lab for analysis.
  • You can seek the result after about 72 hours.
  • You will be driven home by your partner or friend.
  • Upon reaching home, you should be resting for the remainder of the day.
  • You may resume your normal daily activities the next day.
  • Call your doctor if you notice any vaginal bleeding or fluid leakage.
  • Follow every prescribed medication.

CORDOCENTESIS RESULTS

At the instance of your result, your doctor or a genetic professional will explain the result to you. 

Cordocentesis indications from results are as follows:

  • If your test results are normal, your doctor will advise you on the need for a follow-up appointment.
  • If the result shows a fetal infection, your doctor will discuss the treatment options. 
  • As a result of the baby having severe anemia, your baby might need a blood transfusion through the umbilical cord.
  • If your baby has a condition that can’t be treated, you may have unpleasant decisions: whether to terminate the pregnancy or continue.
  • At the bleak hour where you’d have to make a decision, seek support from your healthcare advisers and (most of all) from your loved ones.

CONCLUSION

When cordocentesis test is carried out by highly skilled medical specialists and optimal culture conditions are readily available.

A cordocentesis test is an invasive prenatal diagnostic test and therapeutic procedure that is performed next to amniocentesis, with high accuracy and safety.

FAQs

  • What is a cordocentesis test used for?

Cordocentesis is primarily used to detect and treat blood conditions like anemia of one’s fetus. It is usually done when a diagnosis cannot be carried out with amniocentesis, CVS, ultrasound, or other methods.

  • Is cordocentesis invasive?

Cordocentesis is an invasive procedure that checks the uterus for abnormalities in the fetus, using an ultrasound transducer.

  • How do you take a fetal blood sample?

With the use of an ultrasound, the doctor will insert a very thin needle through your abdomen and uterine wall, into the umbilical cord, to remove the blood sample of your fetus. You will need to lie down in place while he inserts the needle with the guide of an ultrasound.

  • What are the benefits of cordocentesis?

Cordocentesis helps in detecting infections, checking fetal chromosomes, detecting certain genetic disorders, and delivering medications to the fetus. It also helps in the transfusion of blood to the fetus in the uterus.

  • What risk is associated with cordocentesis?

Miscarriage or stillbirth is the most common risk of cordocentesis, and yet the most critical. Every 1 or 2 in 100 pregnancies are affected by this condition. However, not only do miscarriages act as risks of cordocentesis; but there are more, including temporarily slowed heart rate of the fetus, as well as bleeding of the fetus, umbilical cord hematoma, and transfer of infections from the mother to the child.