- Percutaneous umbilical cord blood sampling
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"PUBS" redirects here. For other uses, see PUB (disambiguation).
Percutaneous umbilical cord blood sampling Intervention MeSH D017218 Percutaneous umbilical cord blood sampling (PUBS), also called cordocentesis, is a diagnostic genetic test that examines blood from the fetal umbilical cord[1] to detect fetal abnormalities. PUBS provides a means of rapid chromosome analysis and is useful when information cannot be obtained through amniocentesis, CVS, or ultrasound (or if the results of these tests were inconclusive). This test carries a significant risk of complication and is typically reserved for pregnancies determined to be at high risk for genetic defect.
Contents
Procedure
PUBS is similar to amniocentesis, but instead of sampling the amniotic fluid which surrounds the fetus, PUBS examines fetal blood. An advanced imaging ultrasound determines the location for needle insertion into the placenta, and the needle is guided through the mother's abdomen and uterine wall into the fetal vein of the umbilical cord, where a fetal blood sample is removed. The sample can then be sent for chromosomal analysis. The entire process lasts 45 minutes to an hour. Because the fetal vein is fragile early in pregnancy, PUBS is performed no earlier than 17 weeks into pregnancy.
PUBS testing has a turnaround time of about 72 hours and can detect chromosomal abnormalities, blood disorder, some metabolic disorders, infections, and some causes of structural problems.[2] PUBS has largely replaced fetoscopy, which has a much higher rate of miscarriage.
It has been used with mothers with immune thrombocytopenic purpura.[3]
Risks
Miscarriage is the primary risk associated with PUBS and occurs in 1-2% of procedures. Additional possible complications are similar to those for amniocentesis and include blood loss at the puncture site, infection, and premature rupture of membranes. During the procedure, the mother may feel discomfort similar to a menstrual cramp.
See also
References
- ^ "Human Reproduction, Lectures: Clinical Genetics". http://library.med.utah.edu/kw/human_reprod/lectures/clinical_genetics/. Retrieved 2010-02-11.
- ^ "Penn Pregnancy Health Center: Percutaneous Umbilical Cord Blood Sampling (PUBS)". http://pennhealth.com/health_info/pregnancy/000229.htm. Retrieved 2010-01-01.
- ^ Vianelli N, Baravelli S, Milano V, Rizzo N, Catani L, Tura S (December 1998). "Percutaneous umbilical blood sampling in the management of immune thrombocytopenic purpura during pregnancy". Haematologica 83 (12): 1127–8. PMID 9949634.
External links
Obstetrical surgery and other procedures (ICD-9-CM V3 72-75, ICD-10-PCS 1) Diagnostic sampling: fetal tissue (Chorionic villus sampling · Amniocentesis) · blood (Triple test · Percutaneous umbilical cord blood sampling · Apt test · Kleihauer-Betke test) · Lecithin-sphingomyelin ratio · Fetal fibronectin test
obstetric ultrasonography: Nuchal scan · Biophysical profile (Amniotic fluid index)
other medical imaging: Fetoscopy
Cardiotocography · (Nonstress test) · Vibroacoustic stimulation
challenge: Contraction stress test
Leopold's maneuversIntervention Delivery Vaginal deliveryInduction (Artificial rupture of membranes/Amniotomy) · Episiotomy · Symphysiotomy · Forceps in childbirth · Ventouse in childbirth
shoulder dystocia (McRoberts maneuver, Woods' screw maneuver, Zavanelli maneuver) · Manual placenta removalPostpartum hemorrhageCategories:- Obstetrical procedures
- Pregnancy tests
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