Cordocentesis is one of the methods of invasive prenatal diagnosis, in which fetal cord blood is taken for further examination.. This procedure is performed no earlier than the 18th week of pregnancy, the optimal period is 22-24 weeks. Cordocentesis is indicated for the detection of chromosomal and hereditary diseases, the establishment of Rhesus conflict and hemolytic disease of the fetus, according to the Internet edition for girls and women from 14 to 35 years old Pannochka. net Cordocentesis is carried out under the control of sonography (ultrasound), through the anterior abdominal wall of the expectant mother, a puncture is made with a thin puncture needle, and thus enters the umbilical cord vessel. 1-5 ml of umbilical cord blood is enough for the study. Cordocentesis results are ready within a week.

Before the procedure, the pregnant woman must take written consent and explain all the possible risks from this invasive procedure. The doctor sets the indications for cordocentesis, but the decision should be made by the pregnant woman herself, after weighing all the possible risks and the feasibility of the study..

Indications for cordocentesis High risk of chromosomal disorders (according to the results of biochemical screening);

Identification of abnormalities during fetal ultrasound that may be associated with chromosomal diseases (for example, a short femur, underdevelopment of nasal bones, etc.).

The presence of hereditary diseases in parents if they already have children with congenital developmental disabilities;

Suspicion of Rh conflict, intrauterine infection;

Suspicion of hemophilia;

In addition, therapeutic measures may be indications for cordocentesis.. With this procedure, it is possible to introduce therapeutic agents into the vessels of the umbilical cord of the fetus (infusion of blood products or drugs).

ContraindicationsCordocentesis is contraindicated in infectious processes, isthmic-cervical insufficiency (cervical insufficiency), with large myoma nodes (in the puncture projection), as well as violations of blood clotting in a pregnant woman. Cordocentesis should also not be performed if there is a threat of miscarriage..

Cordocentesis procedure Before puncture, an ultrasound examination of the fetus is performed to clarify its location, viability, clarify the location of the placenta, the volume of amniotic fluid. It is optimal to perform a puncture of the umbilical cord in its free area, closer to the placenta. If cordocentesis is performed in the third trimester of pregnancy, then the use of CTG (cardiotocography) is mandatory to monitor the condition of the fetus.

Usually anesthesia is not required for cordocentesis.. The procedure time is no more than 15-20 minutes. There are various methods of this manipulation, in some cases, amniocentesis is first done (puncture of the fetal bladder with amniotic fluid sampling), and only then the umbilical cord vessel is punctured. After the puncture, 1-5 ml of umbilical cord blood is aspirated for its further examination (biochemical, genetic and for the presence of infections).

After the end of cordocentesis, the condition of the fetus is monitored (heart rate, motor activity). According to indications, antibacterial drugs are prescribed (to prevent infectious complications), and means to relax the muscles of the uterus.

The results of cordocentesis make it possible to determine the fetal genome with very high certainty, and thus exclude or confirm genetic and chromosomal complications..

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

It is possible to develop bleeding from the puncture area (on average, bleeding lasts no more than 1 minute and stops on its own). To reduce the risk of this complication, it is preferable to use small diameter needles.. An umbilical cord hematoma may form at the puncture site and usually does not affect the fetus.. Usually such complications occur against the background of impaired blood clotting..

Violation of the functional state of the fetus is the most common complication of cordocentesis, the risk of its occurrence increases with increasing gestational age, and in the 3rd trimester is 3-12%. This complication is most often manifested by the occurrence of bradycardia (decreased heart rate) and requires medical treatment..

In 1.4% of cases, abortion may occur. This complication is feared by all women who are offered this procedure.. But the risk is quite small..

Infectious complications in the form of chorioamnionitis are also extremely rare (about 1% of cases) and require appropriate medical treatment..

With a Rh conflict between the mother and the fetus, after cordocentesis, the development of alloimmune cytopenia is possible (in a baby). The risk of this complication increases after cordocentesis through the placenta. This condition requires specific treatment (administration of anti-Rhesus immunoglobulin).

If, according to the results of cordocentesis, fetal diseases are detected, then only parents have the right to decide the future fate of the unborn child.

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