Kordotsentez

Kordotsentez – one of methods of invasive prenatal diagnosis at which the intake of umbilical blood of a fruit is made for its further inspection. This procedure is performed not earlier than the 18th week of pregnancy, term is 22-24 weeks optimum. Kordotsentez is shown for detection of chromosomal and hereditary diseases, establishment a Rhesus factor conflict and a hemolitic disease of a fruit.

Kordotsentez is carried out under control of a sonografiya (ultrasonography), through a front abdominal wall of future mother make a puncture a fine aspirating needle, and thus get to an umbilical cord vessel. For a research 1-5 ml of umbilical blood there are enough. Results of a kordotsentez are ready within a week.

Before holding a procedure it is necessary to take the written consent from the pregnant woman and to explain all possible risks from this invasive procedure. Indications to a kordotsentez are put by the doctor, but the pregnant woman has to make the decision having weighed all possible risks and expediency of a research.

Indications to a kordotsentez

• High risk of chromosomal diseases (by results of biochemical screening);
• Detection of anomalies during ultrasonography of a fruit which can be connected with chromosomal diseases (for example, a short femur, an underdevelopment of nasal bones, etc.);
• Existence at parents of hereditary diseases if they already have children with inborn deviations in development;
• Suspicion on a Rhesus factor conflict, a pre-natal infection;
• Suspicion of hemophilia;

Besides medical actions can be indications to a kordotsentez also. At this procedure introduction to vessels of an umbilical cord of a fruit of remedies (infusion of blood preparations or drugs) is possible.

Contraindications

Kordotsentez is contraindicated at infectious processes, at istmiko-cervical insufficiency (insolvency of a neck of uterus), at big myomatous nodes (in a puncture projection), and also disturbances coagulability of blood at the pregnant woman. Kordotsentez it is also impossible to carry out at threat of abortion.

Procedure of a kordotsentez

Before a puncture ultrasonic examination of a fruit for specification of its arrangement, viability, specification of an arrangement of a placenta, volume of amniotic waters is carried out. It is optimum to carry out an umbilical cord puncture on its free site, is closer to a placenta. If кордоцентез it is carried out in the third trimester of pregnancy, then use of KTG (kardiotokografiya) for control of a condition of a fruit is obligatory.

Usually anesthesia for a kordotsentez is not required. Time of the procedure makes no more than 15-20 minutes. There are various techniques of this manipulation, in certain cases at first do amniocentesis (a puncture of a bag of waters with an intake of amniotic liquid), and only then punktirut an umbilical cord vessel. After a puncture aspirate 1-5 ml of umbilical blood for its further inspection (biochemical, genetic and on existence of infections).

After the termination of a kordotsentez control a condition of a fruit (heart rate, a physical activity). According to indications appoint antibacterial drugs (for prevention of infectious complications), and means for relaxation of muscles of a uterus.

Results of a kordotsentez allow to define a fruit genome with very high reliability, and thus to exclude or confirm genetic and chromosomal complications.

Complications

Complications after carrying out a kordotsentez meet seldom (less than 5% of cases).

Development of bleeding from area of a puncture is possible (on average bleeding lasts no more than 1 minute and stops independently). For reduction of risk of this complication it is preferable to use needles of small diameter. The hematoma of an umbilical cord can be created in the place of a puncture, and as a rule, does not influence a condition of a fruit. Usually such complications arise against the background of the broken coagulability of blood.

Disturbance of a functional condition of a fruit the most frequent complication of a kordotsentez, risk of its emergence increases with increase in term of a gestation, and in the 3rd trimester makes 3-12%. This complication is most often shown by developing of bradycardia (an urezheniya of heart rate) and demands drug treatment.

In 1,4% of cases there can be abortion. To be afraid of this complication all women to whom this procedure is offered. But the risk of its emergence is quite small.

Infectious complications in the form of a horioamnionit also meet extremely seldom (about 1% of cases) and demand the corresponding drug treatment.

At a Rhesus factor conflict between mother and a fruit after a kordotsentez development of an alloimmune cytopenia is possible (at the kid). The risk of this complication increases after a kordotsentez through area of a placenta. This state demands specific treatment (introduction an anti-Rhesus factor immunoglobulin).

If by results of a kordotsentez fruit diseases are revealed, then only parents have the right to decide the future of future child.