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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]
The use of cord blood stem cells in treating conditions such as brain injury [39] and Type 1 Diabetes [40] is already being studied in humans, and earlier stage research is being conducted for treatments of stroke, [41] [42] and hearing loss. [43] Cord blood stored with private banks is typically reserved for use of the donor child only.
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.
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]
Umbilical cord stripping: delayed cord clamping and the stripping of the umbilical cord towards the baby can cause the residual blood in the cord/placenta to enter fetal circulation, which can increase blood volume. [10] The recipient twin in a pregnancy undergoing twin-to-twin transfusion syndrome can have polycythemia. [13]
Anatomy scan image of a human placenta and umbilical cord (colour Doppler rendering) showing central placement of the cord in the placenta and three vessels in the cord, which is the normal physiology. A standard anatomy scan typically includes: [4] Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations