Cordocentesis

 Carrying cordocentesis
 Cordocentesis - a method of invasive prenatal diagnosis, in which the fence is made of fetal cord blood for further testing. This procedure is performed not earlier than 18 weeks of pregnancy, it is the best period of 22-24 weeks. Cordocentesis is indicated for the detection of chromosomal and genetic diseases, the establishment of Rh hemolytic disease of the conflict and the fetus.

Cordocentesis is performed under control of ultrasonography (US), through the abdominal wall of the expectant mother produces fine needle puncture needle, and thus fall into a vessel of the umbilical cord. To investigate enough 1-5 ml of cord blood. Cordocentesis results are ready within a week.

Before the procedure, a pregnant need to take the written consent and to clarify all the possible risks of this invasive procedure. Indications for the doctor puts cordocentesis, but the decision must be taken very pregnant after weighing all the risks and feasibility studies.

Indications cordocentesis

  • High risk of chromosomal disorders (based on biochemical screening);
  • Identification of anomalies during fetal ultrasound, which may be associated with chromosomal diseases (eg, short femur, hypoplasia of the nasal bone and other.);
  • The presence of the parents of hereditary diseases, if they already have children with congenital developmental disorders;
  • Suspicion of Rhesus-conflict, intrauterine infection;
  • Suspicion of hemophilia;

In addition to the testimony of cordocentesis may be therapeutic measures. When the procedure can be introduced into the vessels of the umbilical cord of the fetus medical equipment (infusion of blood or medication).

Contraindications

Cordocentesis is contraindicated in infectious processes, with cervical incompetence (cervical insolvency), with large myoma nodes (in the projection of the puncture) and bleeding disorders in pregnant women. Cordocentesis is also impossible to carry out the threat of termination of pregnancy.

Procedure cordocentesis

Before puncture is performed fetal ultrasound to clarify its position, viability, clarify the location of the placenta, amniotic fluid volume. Optimally perform puncture of the umbilical cord at its free site, close to the placenta. If cordocentesis performed in the third trimester of pregnancy, be sure to use CTG (CTG) to monitor the condition of the fetus.

 Procedure cordocentesis
 Typically, anesthesia is not required for cordocentesis. Treatment time is not more than 15-20 minutes. There are various techniques of manipulation, in some cases, first do an amniocentesis (amniocentesis amniotic fluid with a fence) and only then punctured vessel umbilical cord. After puncture aspirate 1-5 ml of cord blood for further examination (biochemical, genetic, and the presence of infection).

After graduating cordocentesis monitor the condition of the fetus (heart rate, physical activity). According to the testimony prescribe antibiotics (to prevent infectious complications), and the means to relax the muscles of the uterus.

Results cordocentesis can determine the genome of the fetus with a very high reliability and thus eliminate or confirm genetic and chromosomal complications.

Complications

Complications after cordocentesis rare (less than 5% of cases).

Perhaps the development of bleeding from the puncture area (average of the bleeding lasts more than 1 minute and stop on their own). To reduce the risk of this complication is preferable to use a small diameter needle. Cord hematoma can form at the puncture site and usually does not affect the condition of the fetus. Typically, these complications occur against the backdrop of blood clotting.

Violation of the functional state of the fetus is the most frequent complication of cordocentesis, the risk of its occurrence increases with gestational age, and 3 trimester of 3-12%. This complication is most often seen the emergence of bradycardia (heart rate deceleration) and requires medical treatment.

At 1, 4% of cases can occur abortion. This complication afraid of all women who are invited to this procedure. But the risk of its occurrence is quite small.

Infectious complications such as chorioamnionitis and are extremely rare (about 1%) and require appropriate medical treatment.

If Rhesus conflict between mother and fetus after cordocentesis may develop alloimmune cytopenias (the baby). The risk of complications increases after cordocentesis through the area of ​​the placenta. This condition requires a specific treatment (administration of anti-Rhesus immunoglobulin).

If the results of cordocentesis revealed diseases of the fetus, the parents only have the right to decide the fate of the unborn child.





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