Cordocentesis

Cordocentesis also known as percutaneous umbilical blood sampling is a diagnostic prenatal test in which a sample of the baby's blood is removed from the umbilical cord for testing.

Uses of Cordocentesis #

• Cordocentesis is used primarily to detect and treat blood conditions, such as fetal anemia a low amount of healthy red blood cells in a developing baby.

• Cordocentesis is usually done when a diagnosis can’t be made from amniocentesis, chorionic villus sampling, ultrasound or other methods.

• Cordocentesis carries a higher risk of complications to the baby, including death, than other procedures do.

• Your health care provider will offer the procedure only if other options aren’t available or they won’t produce results quickly enough.

• Rarely, cordocentesis might be used to check fetal chromosomes through chromosome microarray or karyotype analysis.

• Blood obtained through cordocentesis can also potentially be used for other types of genetic studies.

Procedure of Cordocentesis #

During the procedure #

• About 30 to 60 minutes before the procedure, you might be given antibiotics to reduce the risk of a uterine infection.

• This is usually done through a tube inserted into a vein.

• Your health care provider will use ultrasound to determine the umbilical cord’s location in your uterus.

• You’ll lie on your back on an exam table, and your health care provider will apply a special gel to your belly.

• He or she will then use a small device known as an ultrasound transducer to show your baby’s position on a monitor.

• Next, your health care provider will clean your belly.

• Sometimes medication is given to prevent discomfort during the procedure, but often it isn’t needed.

• Guided by ultrasound, your health care provider will insert a thin, hollow needle through your abdominal wall and into your uterus.

• A small amount of blood from the vein in the umbilical cord will be withdrawn into a syringe, and the needle will be removed.

• You’ll need to lie still while the needle is inserted and the blood is withdrawn.

• You might notice a stinging sensation when the needle enters your skin, and you might feel cramping when the needle enters your uterus.

After the procedure #

• After the blood sample is taken, you might have cramping or a small amount of discomfort.

• Your health care provider will use an ultrasound or an external labor monitor to track your baby’s heart rate after the procedure.

• When you go home, your health care provider might suggest resting for the remainder of the day.

• You’ll likely be able to resume normal activities the next day.

• Call your health care provider if you experience vaginal bleeding or fluid leakage.

• The blood sample will be analyzed in a lab. Test results are typically available within days.

Results of Cordocentesis #

• Your health care provider or a genetic professional will help you understand the results of your cordocentesis.

• If your test results are normal, your health care provider will discuss the need for any follow-up appointments.

• If your baby has an infection, your health care provider will explain the treatment options.

• If your baby has severe anemia, he or she might need a blood transfusion through the umbilical cord.

• If your test results indicate that your baby has a condition that can’t be treated, you might be faced with wrenching decisions such as whether to continue the pregnancy.

• Seek support from your health care team, your loved ones and other close contacts during this difficult time.

Risks of Cordocentesis #

Fetal bleeding #

Bleeding from the area where the needle is inserted is the most common complication. If life-threatening fetal bleeding occurs, your health care provider might recommend replacement of blood products to the fetus.

Cord hematoma #

A collection of fetal blood within the cord might occur during or after a cordocentesis. Most babies don’t have signs or symptoms when this occurs. However, a few might develop a low heart rate for a short period.

Slowing of the baby’s heart rate #

The baby’s heart rate might slow temporarily after cordocentesis.

Infection #

Rarely, cordocentesis can lead to a uterine or fetal infection.

Pregnancy loss #

Cordocentesis carries a higher risk of fetal death than do other prenatal diagnostic tests, such as chorionic villus sampling and amniocentesis. The risk is about 1 to 2 percent for a fetus that appears normal and is being tested for genetic disorders.