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Percutaneous umbilical cord blood sampling (PUBS), also called cordocentesis, fetal blood sampling, or umbilical vein sampling is a diagnostic genetic test that examines blood from the fetal umbilical cord to detect fetal abnormalities. [1] Fetal and maternal blood supply are typically connected in utero with one vein and two arteries to the fetus.
The use of fetal scalp blood testing originated in Germany in 1961 and required 0.25 mL of blood drawn from the fetus. [1] As one of the first methods of monitoring fetal wellbeing during labor, there were many disadvantages including the need for at least 3 cm dilation of the mother and extreme precision from the physician performing the procedure. [9]
Cord blood is composed of all the elements found in whole blood – red blood cells, white blood cells, plasma, platelets. [6] Compared to whole blood some differences in the blood composition exist, for example, cord blood contains higher numbers of natural killer cells, lower absolute number of T-cells and a higher proportion of immature T-cells. [7]
Fetoscopy is an endoscopic procedure during pregnancy to allow surgical access to the fetus, the amniotic cavity, the umbilical cord, and the fetal side of the placenta.A small (3–4 mm) incision is made in the abdomen, and an endoscope is inserted through the abdominal wall and uterus into the amniotic cavity.
During pregnancy, there is normally a barrier between maternal and fetal blood called the placenta, a temporary organ that connects a mother’s uterus to the umbilical cord to provide nutrients and oxygen to the fetus. However, in certain circumstances, small amounts of fetal blood cells may enter the mother’s circulation.
An Intrauterine transfusion (IUT) is a procedure that provides blood to a fetus, most commonly through the umbilical cord. [1] [2] It is used in cases of severe fetal anemia, such as when fetal red blood cells are being destroyed by maternal antibodies, or parvovirus B19 infection, homozygous alpha-thalassemia, or twin-to-twin transfusion syndrome. [3]
It entails sampling of the chorionic villus (placental tissue) and testing it for chromosomal abnormalities, usually with FISH or PCR. CVS usually takes place at 10–12 weeks' gestation, earlier than amniocentesis or percutaneous umbilical cord blood sampling. It is the preferred technique before 15 weeks. [2]
Umbilical cord compression can result from, for example, entanglement of the cord, [16] a knot in the cord, [16] or a nuchal cord, [16] (which is the wrapping of the umbilical cord around the fetal neck) [17] but these conditions do not always cause obstruction of fetal circulation.
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