Percutaneous umbilical blood sampling Down syndrome
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Percutaneous umbilical blood sampling: Results from a multicenter collaborative registry* Author links open overlay panelDurlin E.HickokMD, MPHaPersonMarlinMillsMDbWestern Collaborative Perinatal Group Show
ShareShare Cited ByCite https://doi.org/10.1016/0002-9378(92)91550-TGet rights and content Percutaneous umbilical blood sampling has become an important diagnostic tool in the evaluation of fetal health. Although recent reports have established the safety of this procedure, most have arisen from single centers with extensive experience. The Western Perinatal Collaborative Group has maintained a continuous registry of percutaneous umbilical blood sampling performed at the 13 member institutions for the years 1986 through 1990. During this period 302 procedures were performed. Primary indications for percutaneous umbilical blood sampling included Rh and non-Rh isoimmunization, intrauterine growth retardation, nonimmune hydrops, fetal anomalies, immune thrombocytopenia purpura, and rapid fetal chromosome analysis. Percutaneous umbilical blood sampling was successfully performed in 93.7% of cases with a sample withdrawn by a single puncture in 80.5% of attempts. In the majority of cases a 22-gauge needle was used. Postprocedural fetal death resulted in six cases (2.1%) and was most often associated with fetal anomalies or an abnormal karyotype. In conclusion, evaluation of the fetal state by percutaneous umbilical blood sampling is a safe and easily performed procedure, as demonstrated by a collaborative multicenter study.
Key wordsPercutaneous umbilical blood sampling fetal anomalies Rh isoimmunization Recommended articles
* Presented at the Fifty-eighth Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society, Ashland, Oregon, September 9–12, 1991. aFrom the Center for Pennatal Studies, Swedish Hospital Medical Center and Departments of Epidemiology and Obstetrics and Gynecology, University of Washington Cordocentesis is an invasive prenatal procedure. It can obtain a sample of blood from a fetus’s umbilical cord to detect blood disorders, infections and genetic mutations. It can also be used to deliver medications or blood transfusions to a fetus. The procedure can cause complications, such as early delivery by emergency C-section or miscarriage.
OverviewWhat is cordocentesis?Cordocentesis is a prenatal test that takes a sample of blood from a fetus’s umbilical cord to detect abnormalities. It can diagnose certain problems before a baby is born, such as genetic mutations (changes), blood diseases and infections. In addition, the procedure can deliver medications or blood transfusions to a fetus through the umbilical cord. It’s also called percutaneous umbilical cord blood sampling (PUBS) or funipuncture. Why is cordocentesis performed?Routine prenatal testing includes prenatal ultrasonography and blood work. If noninvasive prenatal testing reveals a possible problem, your healthcare provider may recommend invasive testing, such as amniocentesis or chorionic villus sampling. If results still aren’t clear, your healthcare provider may suggest cordocentesis. What does cordocentesis test for?The test can help diagnose certain conditions in a fetus:
When is cordocentesis performed?Healthcare providers perform cordocentesis any time after the 17th week of pregnancy. Who performs the cordocentesis procedure?The procedure occurs in an office or hospital, usually by an obstetrician, a specialist in pregnancy and childbirth. Is cordocentesis invasive?Cordocentesis is an invasive procedure. It’s used only after other types of testing don’t provide enough information. Test DetailsHow do I prepare for cordocentesis?Your healthcare provider will give you specific instructions to help you prepare for the test. You may have to fast (avoid food and drink, other than water) for several hours in case cordocentesis leads to an emergency C-section. Your healthcare provider may give you IV antibiotics before the procedure to help prevent infection. They also may take a sample of your blood so they can compare it to the fetus’s blood. Consider asking a loved one to come to the appointment. They can provide emotional support and drive you home afterward. What can I expect during cordocentesis?To perform cordocentesis, a healthcare provider will:
Cordocentesis can also deliver medications or treatments. For example, if a fetus has anemia, the procedure can deliver a blood transfusion. What can I expect after cordocentesis?After cordocentesis, your healthcare provider may monitor the fetal heart rate for a short period of time. You may experience cramping or feel a bit uncomfortable after the test. Consider taking it easy for the rest of the day. What are the risks of cordocentesis?Percutaneous umbilical blood sampling is an invasive procedure with significant risk. It can cause miscarriage in about 1 or 2 of every 100 procedures. The test also sometimes leads to early delivery by emergency C-section. Other risks include:
Results and Follow-UpWhen should I know the results of cordocentesis?The results of cordocentesis are usually available in a few days. What do the results of cordocentesis mean?Your healthcare provider and perhaps a genetic counselor will help you understand the results of cordocentesis. If the results are normal, you may still need several follow-up appointments to monitor your health and the fetus’s health. If cordocentesis detects a problem, your healthcare provider will discuss treatment options, which vary widely, such as:
When should I call my healthcare provider after cordocentesis?After cordocentesis, call your healthcare provider if you experience:
A note from Cleveland Clinic Cordocentesis is an invasive prenatal procedure. It’s performed to take a sample of blood from a fetus’s umbilical cord to detect certain abnormalities. It can also deliver medications and blood transfusions when needed. If you’re concerned about your fetus’s health, talk to your healthcare provider about the risks and benefits of prenatal testing. Share Facebook Twitter LinkedIn Email Print Last reviewed by a Cleveland Clinic medical professional on 10/31/2022. References
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What is the main cause of fetal demise or loss associated with invasive percutaneous umbilical cord sampling?The presumed causes of pregnancy losses following cordocentesis are: chorioamnionitis, premature rupture of the membranes, fetal exsanguination, severe bradycardia and cord haematoma. The duration and difficulty of the procedure are major risk factors.
Can you tell if a baby has Down syndrome in an ultrasound?An ultrasound can detect fluid at the back of a fetus's neck, which sometimes indicates Down syndrome. The ultrasound test is called measurement of nuchal translucency. During the first trimester, this combined method results in more effective or comparable detection rates than methods used during the second trimester.
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