in the name of god. cordocentesis cordocentesis and iut - history 1963 - first intraperitoneal...
TRANSCRIPT
IN THE NAME OF GOD
Cordocentesis
Cordocentesis and IUT - History
• 1963 - First intraperitoneal transfusion (Liley)• 1974 - Fetoscopy to obtain fetal samples
(Hobbins, et al)• 1981 - Fetoscopic transfusion (Rodeck, et al)• 1982 - First ultrasound guided IUT (Bang,
Bock & Troll)• 1983 - First large study of IUT - 66 cases
(Daffos, et al)
Why Cordocentesis?•Identify genetic disorders if amniocentesis or Chorionic Villi Sampling unsuccessful or inconclusive.
•Detect fetal blood disorders such as hemophilia, anemia, and blood oxygen levels.
•Detect viral infections (rubella, toxoplasmosis, cytomegalovirus).
•Recommended for mothers known to be sensitized to Rh factor .
Training
Procedure•Usually performed as outpatient.
•Mother provided a sedative to reduce her and fetus movement.
•Fetus may be injected with medicine to stop movement.
•Mother may be given antibiotics to prevent infection or preterm labor.
•Local anesthetic is injected into abdomen.
•Ultrasound is used to locate placental cord insertion.
•Ultrasound imaging guides needle insertion into umbilical vein.
•Small amount of blood is withdrawn.
Procedure
Procedure
Sonographic Appearance
Risks/Complications of Cordocentesis
• Fetal Loss - risk variable depending on condition of fetus, overall 1-2%, range <1% - 50%.
• Bradycardia - common but usually transient(3-12%).
• Bleeding - usually transient and mild(50%)
• Preterm Labor
Risks/Complications
• Preterm Rupture of Membranes• Infection – lower than 1%• Cord Hematoma - rare, much more common
with infusions.• Maternal Alloimmunization - largely
preventable with Rhogam.• Failed Procedure- 5 – 9 %