Cordocentesis, also referred to as Percutaneous Umbilical Cord Blood Sampling (PUBS) test, is a prenatal

diagnostic test that can be used to determine whether there are any abnormalities present in a fetus. It
consists of taking a sample of the fetus’s blood from the umbilical cord for further testing.

The test is typically performed after the 18th week of pregnancy and can test for certain genetic
conditions, blood disorders, and various infections. If need be, the procedure can also be used to give
medication to the fetus through the umbilical cord, as well as blood transfusions.

Cordocentesis isn’t being used as much as it has in the past because there are other prenatal diagnostic
tests that can be used instead that are less risky to the fetus, like amniocentesis or chorionic villus
sampling (CVS). If other tests aren’t yielding enough information, though, cordocentesis is still
performed.

Procedure

Between weeks 18–23, cordocentesis is usually done right in your provider’s office. After 24 weeks, it’s
done in a hospital in case there are any complications that might require an emergency C-section. When
it’s done in the hospital, you’re usually asked to fast after midnight in case surgery is necessary.

First, an ultrasound is done to locate where the umbilical cord inserts into the placenta. Using
ultrasound guidance, a very thin needle is inserted through the abdomen and uterine wall into the
umbilical cord to get the sample of blood. It is then sent to the lab and results typically take around 72
hours.

After the procedure, you and the fetus might be monitored for a bit and you might feel some light
cramping. Your obstetrician or midwife may suggest bed rest for the rest of the day, but you will usually
be able to resume your typical routine the next day.

If you notice anything out of the ordinary like vaginal bleeding or leaking fluid, or develop symptoms like
a fever or chills, it’s important that you call your maternity care provider.

Risks

As with any procedure, cordocentesis does carry risks to both the mom and the fetus. While safe, it is
considered an invasive procedure. According to the American Pregnancy Association, miscarriage is the
main risk of cordocentesis, with one to two miscarriages for every 100 procedures. The procedure does
have a higher risk of miscarriage than other prenatal diagnostic tests, which is why its popularity is
declining.
Other possible risks of cordocentesis can include:

Fetal bleeding

Cord hematoma

Slowing of fetal heart rate

Infection

Fetal-maternal bleeding

Premature rupture of membranes (PROM)

Before deciding to go through with the procedure, talk with your doctor about all of the possible risks
and what this might mean for you. Depending on your medical situation, location of the placenta, the
health of the fetus, and your medical history, your doctor will be able to discuss whether this is an
appropriate procedure to undergo and what risks are most pertinent to you.

Results

People decide to have cordocentesis performed for a variety of reasons, especially if the other prenatal
diagnostic tests are unable to be done for any reason. Although the procedure cannot test for neural
tube defects, it can detect chromosomal abnormalities, blood disorders, fetal malformations, fetal
infection, and fetal anemia.

An important thing to remember is that though the test is able to detect any abnormalities or issues
with a high degree of accuracy, the test does not measure the severity of these issues. Your maternity
care provider, along with a genetics professional, can help you navigate any results you get, answer
questions you might have, and provide you with all of the information and options available to you.

If you decide to have the procedure done, the results can help you start planning for a child with
different needs, find support groups and resources, or start exploring medical treatments for your child.
You might also choose not to have the procedure done, which is also a valid decision.

Cordocentesis can be a valuable prenatal diagnostic test when other tests are not able to be performed.
As with any medical procedure, it does have its risks. If your provider mentions cordocentesis, talk with
her about why the test is being recommended, the particular risks and benefits to you and your
situation, and what other options are available to you.

Cordocentesis — also known as percutaneous umbilical blood sampling — is a diagnostic prenatal test in
which a sample of the baby's blood is removed from the umbilical cord for testing.

Cordocentesis, which is usually done after week 18 of pregnancy, can be used to detect certain genetic
disorders, blood conditions and infections. Cordocentesis can also be used to deliver blood and
medication to a baby through the umbilical cord.

Use of cordocentesis is becoming rare because diagnostic procedures such as amniocentesis and
chorionic villus sampling, which pose a lower risk of fetal death, can be used instead for prenatal
diagnosis of disease. Cordocentesis is most often done to test for anemia in the baby.

Why it's done

Cordocentesis is used primarily to detect and treat blood conditions, such as fetal anemia — a low
amount of healthy red blood cells in a developing baby.

Cordocentesis is usually done when a diagnosis can't be made from amniocentesis, chorionic villus
sampling, ultrasound or other methods. Cordocentesis carries a higher risk of complications to the baby,
including death, than other procedures do. Your health care provider will offer the procedure only if
other options aren't available or they won't produce results quickly enough.

Rarely, cordocentesis might be used to check fetal chromosomes through chromosome microarray or
karyotype analysis. Blood obtained through cordocentesis can also potentially be used for other types of
genetic studies.

Risks

Cordocentesis carries potentially serious risks, including:

Fetal bleeding. Bleeding from the area where the needle is inserted is the most common complication. If
life-threatening fetal bleeding occurs, your health care provider might recommend replacement of
blood products to the fetus.

Cord hematoma. A collection of fetal blood within the cord might occur during or after a cordocentesis.
Most babies don't have signs or symptoms when this occurs. However, a few might develop a low heart
rate for a short period.

If the hematoma is stable, your health care provider will observe the baby. If the hematoma isn't stable
or if your baby's heart rate doesn't recover, your health care provider will recommend an emergency
cesarean delivery.

Slowing of the baby's heart rate. The baby's heart rate might slow temporarily after cordocentesis.

Infection. Rarely, cordocentesis can lead to a uterine or fetal infection.

Fetal-maternal bleeding. Fetal blood might enter maternal circulation in about 40 percent of
procedures. The amount of bleeding is usually small. This problem is more common when the placenta
lies in the front of the uterus.

Passing maternal infection. If the mother has certain infections, such as hepatitis B, hepatitis C or HIV,
they might be passed to the baby.

Pregnancy loss. Cordocentesis carries a higher risk of fetal death than do other prenatal diagnostic tests,
such as chorionic villus sampling and amniocentesis. The risk is about 1 to 2 percent for a fetus that
appears normal and is being tested for genetic disorders.

However, since many babies are ill when the test is done, it's often difficult to determine whether fetal
death is related to the procedure or to the baby's health.

Ultimately, the decision to have cordocentesis is up to you. Your health care provider and a genetic
professional can help you weigh the risks and benefits.

How you prepare

If you are 23 or more weeks pregnant, you'll be asked to avoid eating or drinking after midnight the
night before cordocentesis. This is because certain complications caused by the procedure might require
an emergency cesarean section.

You might want to ask your partner or a friend to accompany you to the appointment for emotional
support or to drive you home afterward.

What you can expect

Before week 23 of pregnancy, cordocentesis is usually done in an outpatient facility or the health care
provider's office. After week 23 of pregnancy, cordocentesis is usually done in the hospital, in case the
baby develops complications that might require an emergency delivery.

A sample of your blood will be taken before the procedure for comparison with the fetal blood samples.

During the procedure

About 30 to 60 minutes before the procedure, you might be given antibiotics to reduce the risk of a
uterine infection. This is usually done through a tube inserted into a vein.

Your health care provider will use ultrasound to determine the umbilical cord's location in your uterus.
You'll lie on your back on an exam table, and your health care provider will apply a special gel to your
belly. He or she will then use a small device known as an ultrasound transducer to show your baby's
position on a monitor.

Next, your health care provider will clean your belly. Sometimes medication is given to prevent
discomfort during the procedure, but often it isn't needed.

Guided by ultrasound, your health care provider will insert a thin, hollow needle through your
abdominal wall and into your uterus. A small amount of blood from the vein in the umbilical cord will be
withdrawn into a syringe, and the needle will be removed.
You'll need to lie still while the needle is inserted and the blood is withdrawn. You might notice a
stinging sensation when the needle enters your skin, and you might feel cramping when the needle
enters your uterus.

After the procedure

After the blood sample is taken, you might have cramping or a small amount of discomfort.

Your health care provider will use an ultrasound or an external labor monitor to track your baby's heart
rate after the procedure.

When you go home, your health care provider might suggest resting for the remainder of the day. You'll
likely be able to resume normal activities the next day. Call your health care provider if you experience
vaginal bleeding or fluid leakage.

The blood sample will be analyzed in a lab. Test results are typically available within days.

Results

Your health care provider or a genetic professional will help you understand the results of your
cordocentesis. If your test results are normal, your health care provider will discuss the need for any
follow-up appointments.

If your baby has an infection, your health care provider will explain the treatment options. If your baby
has severe anemia, he or she might need a blood transfusion through the umbilical cord.

If your test results indicate that your baby has a condition that can't be treated, you might be faced with
wrenching decisions — such as whether to continue the pregnancy. Seek support from your health care
team, your loved ones and other close contacts during this difficult time.