Treatments & Therapies

Umbilical cord puncture – treatment, effects & risks

Umbilical cord puncture

The umbilical cord puncture is an invasive examination method in prenatal diagnostics . A small amount of blood is taken from the umbilical cord of the unborn child . It is used to identify diseases and genetic defects in the child.

What is umbilical cord puncture?

After taking the blood through the umbilical cord puncture ( chordocentesis ), it can be examined for blood group incompatibility with the mother, metabolic disorders , toxoplasmosis or rubella . Toxoplasmosis is a cat disease that is normally completely harmless to humans and can be transmitted to humans (zoonosis). Serious damage to the unborn child can only occur if the mother falls ill for the first time in the first trimester of pregnancy.

If the mother was ill earlier or the infection occurs later, this is not dangerous for the unborn child. In addition, the blood can be searched for hereditary diseases and chromosome abnormalities. If anemia is present, the unborn child can receive a blood transfusion through the umbilical cord . The umbilical cord puncture is also used to administer medication for infectious diseases . It is not possible to cure hereditary diseases or chromosomal abnormalities.

Function, effect & goals

At the beginning of the umbilical cord puncture, the doctor determines the exact position of the baby with the help of an ultrasound device . Then he looks for an easily accessible part of the umbilical cord. This should be close to the placenta. A very thin hollow needle is inserted into the umbilical cord through the mother’s building ceiling and one to two mm of blood is taken. This examination is completely painless for the baby. The mother does not usually have to be anesthetized for this either.

The umbilical cord puncture can be performed from the 18th week of pregnancy. This examination is advisable if the mother has had abnormal blood values, previous ultrasound examinations have provided abnormal findings or to confirm the results of an amniotic fluid test (amniocentesis), a chorionic villi biopsy (examination of the placenta) or a related FISH test.

Chromosomal abnormalities that can be detected by this examination are Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), Patau syndrome (trisomy 13) or Klinefelder syndrome. The Edwards and Patau syndromes lead to serious damage to the unborn child and to an extremely short life expectancy.

Klinefelder syndrome is a chromosomal abnormality that only occurs in male babies. Your chromosome set has one or more extra x chromosomes. Men affected by this chromosomal abnormality are very feminine in appearance and are usually infertile. This chromosome deviation has no further effects. Due to the risk of complications, the umbilical cord puncture should not be performed without a compelling reason. Depending on what exactly is to be examined, the result of the examination is available after a few hours or within a few days. Determining genetic abnormalities takes longer than determining infection or anemia.

Risks, side effects & dangers

The most common side effect of an umbilical cord puncture is uterine contraction . It feels like a stomach ache . In most cases, however, this is harmless and subsides relatively quickly. Penetrating the needle can cause infection. Light bleeding from the uterus and loss of amniotic fluid are also possible. The uterus or placenta can also be injured. If the child moves unexpectedly during the examination, it can easily be injured by the puncture needle.

Therefore, constant monitoring with the help of ultrasound during the examination is essential. The most serious complication that can occur is a miscarriage . The risk is between 1% and 3% and depends on both the skill and experience of the doctor and the age of the mother. If the unborn child is given a blood transfusion through the puncture needle, a so-called umbilical cord tamponade can occur. 

Here, the blood is not introduced into the umbilical cord, but into the surrounding tissue . In this case, the child must be born immediately by caesarean section, as there is a risk of undersupply. Blood from the unborn child can also enter the mother’s bloodstream through the puncture. In most cases this is not a problem.

This only becomes dangerous if there is blood group incompatibility between mother and child, because the mother’s bloodstream begins to form antibodies against the child’s blood. These antibodies can cross the placental barrier relatively easily. In the bloodstreamof the unborn child, they would cause considerable problems and, in extreme cases, lead to permanent deformities or death. 

Therefore, in such a case, the mother is given a drug as a preventive measure. Due to the relatively high risk of miscarriage and the possibility of further complications, an umbilical cord puncture should only be performed if previous tests and examinations have revealed a reasonable suspicion of a disease in the unborn child or a chromosomal abnormality.

In these cases, too, the benefit and the individual risk must be thoroughly clarified with the doctor treating you before the procedure. If there is a suspicion of a chromosome deviation, it should be agreed in advance with the partner what should happen if the suspicion is confirmed. 

A cure is not possible in these cases. Depending on the type of trisomy, the child only has a very limited life span after birth. In these cases, the question arises as to whether an abortion is an option and if so, in which cases? Special psychological counseling is offered for parents in this situation.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.