Umbilical cord puncture

Nicole Wendler holds a PhD in biology in the field of oncology and immunology. As a medical editor, author and proofreader, she works for various publishers, for whom she presents complex and extensive medical issues in a simple, concise and logical manner.

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The umbilical cord puncture is a voluntary examination in the field of invasive prenatal diagnosis. The doctor uses a long needle to take childish blood from the umbilical cord. In the subsequent fetal blood analysis, diseases in the unborn child can be determined, some of which can already be treated in the womb. Read more about this and how umbilical cord puncture can also be used to treat diseases here!

Umbilical cord puncture: focus on childlike blood

Umbilical cord puncture is an invasive method of prenatal diagnosis. The doctor punctures the umbilical cord of the unborn child with a thin hollow needle and takes a small amount of blood, which is then analyzed in more detail in the laboratory. The procedure is painless for both mother and child. The following values are determined as part of the fetal blood analysis:

Blood count / hematocrit: erythrocytes, lymphocytes, platelets
Blood group and rhesus factor (Rh)
hemoglobin
Serum bilirubin
antibody

In addition, the blood sample obtained by umbilical cord puncture can be used to analyze the child's chromosomes. To do this, the child's cells from the blood sample are enriched in a cell culture before their genetic material is examined more closely.

Detection of diseases and chromosomal disorders

The analysis of these child's blood values can help determine certain diseases in the unborn child. These include:

Anemia
Infections (toxoplasmosis, rubella, rubella, etc.)
Metabolic disorders
Hydrops fetalis (accumulation of fluid in the child's body)

to clarify chromosomal disorders and hereditary diseases if, for example, an amniocentesis or another prenatal diagnostic method has not produced a clear result.

Treatment in the womb

Some of these diseases can be treated in the womb. Doctors then speak of prenatal invasive therapy. The doctor again uses the umbilical cord access to direct the necessary medication into the child's body (intrauterine transfusion). For example, anemia or an infection with rubella can be brought under control with a blood transfusion via the umbilical cord. Further therapies via the umbilical cord are possible for cardiac arrhythmias (administration of antiarrhythmics) or thyroid diseases (administration of thyroid hormones).

Sometimes babies need surgery while they are still in their womb. For these so-called intrauterine interventions, the unborn child can receive an anesthetic via the umbilical cord puncture.

This is how the umbilical cord puncture works

The umbilical cord puncture is usually performed on an outpatient basis. First, the doctor checks the position of your child with the ultrasound device (sonography). Once he has found a suitable puncture site and disinfected the corresponding area of skin, he pushes a thin hollow needle under careful ultrasound control through your abdominal wall into the amniotic sac and further into the umbilical vein. The doctor takes about two to three milliliters of child's blood and then carefully pulls the hollow needle out again.

The puncture points in the umbilical cord, fruit cavity and abdominal wall close again shortly after the puncture. After about 20 minutes, the doctor will check again whether your child is fine. If everything is okay, you can leave the hospital or practice again. The result of the umbilical cord puncture is available after about three to four days.

Risks of umbilical cord puncture

After the umbilical cord puncture, you should take it easy and take care of your body. Contact a doctor immediately if there are any signs of complications. Such complications are somewhat more common with umbilical cord puncture than with other prenatal diagnostic methods (amniotic fluid examination, chorionic villus sampling). These include:

Uterine contractions (common)
infection
premature labor
Miscarriage
Umbilical cord hematoma (may affect the child's care and may require an emergency caesarean section)

To keep the risk of complications as low as possible, you should only have an umbilical cord puncture performed in specialized centers and by experienced doctors.

Umbilical cord puncture: Not a routine

The umbilical cord puncture is not a routine examination during pregnancy. Rather, it is a voluntary examination that a pregnant woman can have carried out on the advice of her doctor if certain childhood diseases and chromosomal disorders are suspected. Before doing this, the doctor must carefully explain the benefits and risks of the procedure to the woman.

In principle, umbilical cord puncture is possible from the 12th week of pregnancy, but it is technically difficult at this early stage. It is easier for the doctor from around the 18th week of pregnancy. In order to be able to detect childhood infections by means of umbilical cord puncture, the fetus must have reached the 22nd week of pregnancy. Only then does it form IgM antibodies that indicate an infection. Before this week of pregnancy, suspected infection in the child can only be clarified by means of amniocentesis or chorionic villus sampling.

An umbilical cord puncture should not be performed if the mother has a disease that can be passed on to the unborn child during the procedure (such as HIV, hepatitis).

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