The collecting of fetal blood samples typically via ENDOSCOPIC ULTRASOUND GUIDED FINE NEEDLE ASPIRATION from the umbilical vein.
Pathophysiological conditions of the FETUS in the UTERUS. Some fetal diseases may be treated with FETAL THERAPIES.
Determination of the nature of a pathological condition or disease in the postimplantation EMBRYO; FETUS; or pregnant female before birth.
The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.
Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the PLACENTA. The cord blood is blood contained in the umbilical vessels (UMBILICAL CORD) at the time of delivery.
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated as the time from the last day of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization.
The failure of a FETUS to attain its expected FETAL GROWTH at any GESTATIONAL AGE.

Intrauterine management of fetal parvovirus B19 infection. (1/34)

OBJECTIVES: The aim of our study was to determine the outcome of pregnancies after intrauterine management of fetal parvovirus B19 infection. DESIGN: Retrospective study. SUBJECTS: A total of 37 cases of maternofetal parvovirus B19 infection, 35 of which were associated with hydrops fetalis, were referred to our tertiary level center between 1989 and 1996. With regard to fetal hydrops, no apparent cause other than parvovirus B19 infection was found in any patient. METHODS: In all patients, cordocentesis was performed to assess the degree of fetal anemia. When anemia was present, cordocentesis was followed by intrauterine transfusion with packed red cells into the umbilical vein. Further management depended on the degree of fetal anemia and gestational age and included follow-up fetal blood sampling/transfusion as well as ultrasound examinations as deemed appropriate. RESULTS: Packed red cell transfusion was performed in 30 patients with significant fetal anemia (Z-score 1.6-7.8 below the mean for gestational age). The fetal hemoglobin values ranged from 2.1 to 9.6 g/dl. Serum levels of platelets in the transfusion group were 9-228 x 10(9)/l with Z-scores in the range of < 1 to 3.8 below the mean. During treatment and follow-up, there were five intrauterine deaths (13.5%), one neonatal death (2.7%) and 31 live births (83.8%). CONCLUSIONS: Fetal parvovirus infection can lead to marked anemia and hydrops formation. Cordocentesis allows precise assessment of fetal anemia which can then be corrected by intravenous transfusion. Under this regimen, the outcome proved favorable in the majority of fetuses, even those that were severely anemic.  (+info)

Maternal compound W serial measurements for the management of fetal hypothyroidsm. (2/34)

OBJECTIVE: The diagnosis of fetal hypothyroidism is based at present on measurements of TSH and free thyroxine (FT4) in fetal blood samples obtained by cordocentesis. The measurement of maternal serum and urinary concentrations of compound W, immunologically similar to but chromatographically distinct from diiodothyronine sulfate (T2S), has been advocated as a new possible marker for fetal hypothyroidism. DESIGN: In this paper, we measured serum compound W levels in 84 pregnant women, 20 with and 64 without thyroid disorders before and during specific treatment. Compound W was also assessed in fetal blood obtained by cordocentesis from 49 normal fetuses and 4 fetuses with suspected hypothyroidism due to transplacental passage of propylthiouracil (PTU). Compound W levels were measured by T2S RIA in maternal and fetal serum. To assess the possible usefulness of 3, 5,3'-triiodothyroacetic acid (TRIAC) for therapy of fetal hypothyroidism we evaluated the transplacental passage of TRIAC by administering the drug to four pregnant women before therapeutic abortion. RESULTS: In normal pregnancies, both maternal and fetal compound W levels increased progressively during gestation with a significant direct correlation (P<0.001, in both mothers and fetuses). Moreover, a significant positive correlation was observed between fetal compound W and fetal FT4 values (P<0.005), whereas no correlation was observed between maternal serum compound W and maternal FT4 in either euthyroid or hyperthyroid women, suggesting the fetal origin of compound W. The hypothyroid fetuses of PTU-treated mothers showed low compound W levels, and maternal compound W values were in the low normal range and did not show the typical increase during progression of gestation. A significant increase of maternal compound W was observed when the PTU dose was reduced. TRIAC was documented to cross the placental barrier and the treatment of a hyperthyroid pregnant woman on PTU caused the high fetal TSH levels and goiter to normalize. CONCLUSIONS: Serial measurements of 3,3'-T2S crossreactive materials (compound W and 3, 3'-diiodothyroacetic acid sulfate) in maternal blood and the administration of TRIAC to the mother may represent a useful and safe alternative to invasive techniques for the diagnosis and therapy of fetal hypothyroidism.  (+info)

Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses. (3/34)

BACKGROUND: Invasive techniques such as amniocentesis and cordocentesis are used for diagnosis and treatment in fetuses at risk for anemia due to maternal red-cell alloimmunization. The purpose of our study was to determine the value of noninvasive measurements of the velocity of blood flow in the fetal middle cerebral artery for the diagnosis of fetal anemia. METHODS: We measured the hemoglobin concentration in blood obtained by cordocentesis and also the peak velocity of systolic blood flow in the middle cerebral artery in 111 fetuses at risk for anemia due to maternal red-cell alloimmunization. Peak systolic velocity was measured by Doppler velocimetry. To identify the fetuses with anemia, the hemoglobin values of those at risk were compared with the values in 265 normal fetuses. RESULTS: Fetal hemoglobin concentrations increased with increasing gestational age in the 265 normal fetuses. Among the 111 fetuses at risk for anemia, 41 fetuses did not have anemia; 35 had mild anemia; 4 had moderate anemia; and 31, including 12 with hydrops, had severe anemia. The sensitivity of an increased peak velocity of systolic blood flow in the middle cerebral artery for the prediction of moderate or severe anemia was 100 percent either in the presence or in the absence of hydrops (95 percent confidence interval, 86 to 100 percent for the 23 fetuses without hydrops), with a false positive rate of 12 percent. CONCLUSIONS: In fetuses without hydrops that are at risk because of maternal red-cell alloimmunization, moderate and severe anemia can be detected noninvasively by Doppler ultrasonography on the basis of an increase in the peak velocity of systolic blood flow in the middle cerebral artery.  (+info)

Prenatal diagnosis of thrombocytopenia-absent-radius (TAR) syndrome. (4/34)

The prenatal diagnosis of thrombocytopenia-absent-radius (TAR) syndrome using ultrasound and cordocentesis in the 16th week of gestation is established. The sonographic findings detected in this case included bilateral absence of the radius and club hands with normal thumbs and metacarpals. Because of a high index of suspicion for the syndrome, cordocentesis for fetal blood analysis was performed. Thrombocytopenia, with a platelet count of 14,000/mm3, was identified. The pregnancy was electively terminated and subsequent findings confirmed the sonographic diagnosis. This report, to our knowledge, is one of a very limited number of cases published in the literature, in which the prenatal diagnosis of TAR syndrome was made.  (+info)

Fetal brain disruption sequence in a newborn infant with a history of cordocentesis at 21 weeks gestation. (5/34)

The case is reported of a full term infant with severe microcephaly, overlapping sutures, prominence of the occipital bone, and scalp rugae. No other associated malformations were observed. The only obstetric history of interest was the performance of cordocentesis at 21 weeks gestational age because of low maternal alpha fetoprotein levels. Ultrasound scans performed until then were normal. Cranial growth retardation was detected on ultrasound scanning at 25 weeks and intrauterine growth retardation as well as severe microcephaly at 34 weeks. Neuroimaging studies performed on the newborn infant showed intense cerebral atrophy in both hemispheres. Other complementary investigations gave negative results. A relation is proposed between the cordocentesis and the development of vascular disruption, which could have caused the fetal brain disruption sequence in this case.  (+info)

Controlled fetal blood-letting of the recipient twin as a new method for the treatment of severe twin-twin transfusion syndrome: preliminary results. (6/34)

OBJECTIVE: To investigate the feasibility of withdrawal of blood from the recipient twin as a new method for the treatment of severe twin-twin transfusion syndrome. METHODS: Seven consecutive monozygotic monochorionic twin pregnancies affected by severe twin-twin transfusion syndrome were treated. Fetal blood was withdrawn from the recipient twin using cordocentesis. The volume of blood to be removed was determined using the formula for intrauterine blood transfusion of anemic fetuses. Fetal outcome was evaluated in relation to changes in the amniotic fluid and in growth curves (comparing the differences between the centiles of the estimated fetal weight before the procedure and the centiles of weight at birth), fetal mortality, gestational age at delivery, neonatal weight and neurological damage. RESULTS: Overall, seven of the 14 (50%) fetuses survived; at least one fetus survived in five (71%) pregnancies, both fetuses survived in two (29%) pregnancies, while in two (29%) pregnancies there were no survivors. No maternal complications were observed. At follow-up, one (14%) baby had minor neurological damage. CONCLUSIONS: Withdrawal of blood from the recipient twin in the treatment of severe twin-twin transfusion syndrome was associated with survival similar to that of the alternative techniques of serial amniodrainage and fetoscopic laser surgery, with some possible advantages such as reduced neurological damage compared with serial amniodrainage. It is also less invasive compared with fetoscopic laser surgery.  (+info)

Teaching ultrasound-guided invasive procedures in fetal medicine: learning curves with and without an electronic guidance system. (7/34)

OBJECTIVE: To compare the learning curves of inexperienced junior obstetrics/gynecology registrars for ultrasound-guided invasive procedures on a training model, with and without an electronic guidance system. STUDY DESIGN: Four junior registrars performed their first 100 procedures on a training model with a new electronic guidance system, and four other junior registrars performed their first 100 procedures on the same training model without using the guidance system. All procedures were performed using a free-hand technique. We evaluated the quality of the procedure, which we defined as the time spent with the entire needle clearly visualized on the screen over the total duration of the procedure. We constructed learning curves for the eight junior registrars for comparative analysis. RESULTS: Quality of the procedure increased over time for all trainees. The learning curves were significantly steeper for trainees using the electronic guidance system. Trainees using the electronic guidance system performed better in the middle of their learning curve (procedures 25-75). All trainees reached the same level of quality by the end of their 100 procedures. CONCLUSIONS: The automated electronic guidance system helps faster learning but, after 100 procedures on a training model, both groups reached the same level of quality.  (+info)

Comparison of feticide carried out by cordocentesis versus cardiac puncture. (8/34)

OBJECTIVE: Feticide may be achieved by the injection of strong potassium chloride (KCl) into the fetal circulation via the cardiac route, or less frequently, into the umbilical cord. Despite the relative frequency of this procedure, little published information is available on the subject. SUBJECTS AND METHODS: This was a retrospective analysis of all feticide procedures carried out prior to legal pregnancy termination in mid trimester of pregnancy from January 1996 to July 2001, in a tertiary fetal medicine referral center. The effect of gestational age and the route of access to fetal the circulation on the dose of strong KCl required to achieve cardiac asystole was evaluated. RESULTS: A total of 106 women underwent the procedure of feticide during the study period. Gestational age had no effect on the dose of strong KCl. The median dose of KCl administered by cordocentesis (5 mL) was significantly less (P < 0.001) than the dose required when fetal cardiocentesis was performed for administration of the drug (10 mL). CONCLUSION: This is the first comparative study of feticide by the administration of strong KCl by fetal cardiocentesis and cordocentesis. The study demonstrates that both cardiac and umbilical routes can be used to achieve feticide effectively, without compromising maternal safety. A finding of this study is that significantly smaller doses of KCl were required to achieve fetal cardiac asystole when using the umbilical compared to the cardiac route, although this may be explained by differences in technique. Strong 15% KCl can safely be used to achieve feticide in volumes up to 20 mL for cardiocentesis and 8 mL for cordocentesis.  (+info)

Cordocentesis, also known as percutaneous umbilical blood sampling (PUBS), is a medical procedure in which a small amount of fetal blood is withdrawn from the umbilical cord for diagnostic testing. It is typically performed when there is a concern for fetal anemia, chromosomal abnormalities, or other genetic disorders. The procedure involves inserting a thin needle through the mother's abdomen and uterus to reach the umbilical cord, usually during the second trimester of pregnancy. Cordocentesis carries a small risk of complications, including fetal injury, infection, and premature labor.

Fetal diseases are medical conditions or abnormalities that affect a fetus during pregnancy. These diseases can be caused by genetic factors, environmental influences, or a combination of both. They can range from mild to severe and may impact various organ systems in the developing fetus. Examples of fetal diseases include congenital heart defects, neural tube defects, chromosomal abnormalities such as Down syndrome, and infectious diseases such as toxoplasmosis or rubella. Fetal diseases can be diagnosed through prenatal testing, including ultrasound, amniocentesis, and chorionic villus sampling. Treatment options may include medication, surgery, or delivery of the fetus, depending on the nature and severity of the disease.

Prenatal diagnosis is the medical testing of fetuses, embryos, or pregnant women to detect the presence or absence of certain genetic disorders or birth defects. These tests can be performed through various methods such as chorionic villus sampling (CVS), amniocentesis, or ultrasound. The goal of prenatal diagnosis is to provide early information about the health of the fetus so that parents and healthcare providers can make informed decisions about pregnancy management and newborn care. It allows for early intervention, treatment, or planning for the child's needs after birth.

Prenatal ultrasonography, also known as obstetric ultrasound, is a medical diagnostic procedure that uses high-frequency sound waves to create images of the developing fetus, placenta, and amniotic fluid inside the uterus. It is a non-invasive and painless test that is widely used during pregnancy to monitor the growth and development of the fetus, detect any potential abnormalities or complications, and determine the due date.

During the procedure, a transducer (a small handheld device) is placed on the mother's abdomen and moved around to capture images from different angles. The sound waves travel through the mother's body and bounce back off the fetus, producing echoes that are then converted into electrical signals and displayed as images on a screen.

Prenatal ultrasonography can be performed at various stages of pregnancy, including early pregnancy to confirm the pregnancy and detect the number of fetuses, mid-pregnancy to assess the growth and development of the fetus, and late pregnancy to evaluate the position of the fetus and determine if it is head down or breech. It can also be used to guide invasive procedures such as amniocentesis or chorionic villus sampling.

Overall, prenatal ultrasonography is a valuable tool in modern obstetrics that helps ensure the health and well-being of both the mother and the developing fetus.

Fetal blood refers to the blood circulating in a fetus during pregnancy. It is essential for the growth and development of the fetus, as it carries oxygen and nutrients from the placenta to the developing tissues and organs. Fetal blood also removes waste products, such as carbon dioxide, from the fetal tissues and transports them to the placenta for elimination.

Fetal blood has several unique characteristics that distinguish it from adult blood. For example, fetal hemoglobin (HbF) is the primary type of hemoglobin found in fetal blood, whereas adults primarily have adult hemoglobin (HbA). Fetal hemoglobin has a higher affinity for oxygen than adult hemoglobin, which allows it to more efficiently extract oxygen from the maternal blood in the placenta.

Additionally, fetal blood contains a higher proportion of reticulocytes (immature red blood cells) and nucleated red blood cells compared to adult blood. These differences reflect the high turnover rate of red blood cells in the developing fetus and the need for rapid growth and development.

Examination of fetal blood can provide important information about the health and well-being of the fetus during pregnancy. For example, fetal blood sampling (also known as cordocentesis or percutaneous umbilical blood sampling) can be used to diagnose genetic disorders, infections, and other conditions that may affect fetal development. However, this procedure carries risks, including preterm labor, infection, and fetal loss, and is typically only performed when there is a significant risk of fetal compromise or when other diagnostic tests have been inconclusive.

Pregnancy is a physiological state or condition where a fertilized egg (zygote) successfully implants and grows in the uterus of a woman, leading to the development of an embryo and finally a fetus. This process typically spans approximately 40 weeks, divided into three trimesters, and culminates in childbirth. Throughout this period, numerous hormonal and physical changes occur to support the growing offspring, including uterine enlargement, breast development, and various maternal adaptations to ensure the fetus's optimal growth and well-being.

Gestational age is the length of time that has passed since the first day of the last menstrual period (LMP) in pregnant women. It is the standard unit used to estimate the age of a pregnancy and is typically expressed in weeks. This measure is used because the exact date of conception is often not known, but the start of the last menstrual period is usually easier to recall.

It's important to note that since ovulation typically occurs around two weeks after the start of the LMP, gestational age is approximately two weeks longer than fetal age, which is the actual time elapsed since conception. Medical professionals use both gestational and fetal age to track the development and growth of the fetus during pregnancy.

Fetal growth retardation, also known as intrauterine growth restriction (IUGR), is a condition in which a fetus fails to grow at the expected rate during pregnancy. This can be caused by various factors such as maternal health problems, placental insufficiency, chromosomal abnormalities, and genetic disorders. The fetus may be smaller than expected for its gestational age, have reduced movement, and may be at risk for complications during labor and delivery. It is important to monitor fetal growth and development closely throughout pregnancy to detect any potential issues early on and provide appropriate medical interventions.

Weiner, Carl P.; Lee, Gene T. (2017). "Cordocentesis". Operative Obstetrics. Routledge. doi:10.1201/9781315382739. ISBN 978-1- ...
Orlandi F, Damiani G, Jakil C, Lauricella S, Bertolino O, Maggio A (1990). "The risks of early cordocentesis (12-21 weeks): ... 1997). "Application of the 'Apt test' in prenatal diagnosis to evaluate the fetal origin of blood obtained by cordocentesis: ... Weiner C, Grant S, Hudson J, Williamson R, Wenstrom K (1989). "Effect of diagnostic and therapeutic cordocentesis on maternal ... ISBN 1-58890-147-5. Abdel-Fattah, Sherif A (2004). "Safety of fetal blood sampling by cordocentesis in fetuses with single ...
Between 1985 and 1988, Shalev demonstrated the regular use of ultrasound to conduct cordocentesis, a novel procedure at the ... "Prenatal diagnosis using sonographic guided cordocentesis." Journal of Perinatal Medicine. 17 (6): 393-8. DOI PMID "איני עוסק ...
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Bhide, A; Sairam, S; Hollis, B; Thilaganathan, B (Sep 2002). "Comparison of feticide carried out by cordocentesis versus ...
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Weiner, Carl P.; Lee, Gene T. (2017). "Cordocentesis". Operative Obstetrics. Routledge. doi:10.1201/9781315382739. ISBN 978-1- ...
Predicting neonatal thrombocytopenia with cordocentesis. J Reprod Med. 1997 May. 42(5):276-80. [QxMD MEDLINE Link]. ...
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Placenta penetration during cordocentesis has been associated with a higher risk for fetal loss, preterm birth, and low birth ... In early labor, a fetal platelet count may be obtained via cordocentesis or a scalp blood smear. If the count is less than ... Complications associated with cordocentesis are more common in posterior placentae and when the procedure is performed prior to ... Serial cordocentesis is indicated for severely affected fetuses for direct measurement of hematocrit (Hct), reticulocyte count ...
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  • These treatments include fetoscopic selective laser photocoagulation, cordocentesis, radiofrequency ablation, and fetal surgery for spina bifida and certain heart disorders. (nyp.org)
  • Management of fetal hemolytic disease by cordocentesis. (bvsalud.org)
  • alternatively, cordocentesis to measure fetal haemoglobin levels is carried out in some centres. (primarycarenotebook.com)
  • Percutaneous umbilical blood sampling (PUBS) , also called cordocentesis. (medlineplus.gov)
  • Cordocentesis, a procedure to check umbilical cord blood and find out how severe your baby's anemia is. (healthychildren.org)