SARASWATI COLLEGE OF NURSING UDAIPUR ,

RJ

Procedure
ON
CORDOCENTESIS

Submitted To: Mrs. HariBala Paliwal

(Associate Professor)

(Head of Deptt.)

OBG

Submitted By: Shabnam Amin

M. Sc. Nursing
(1st year)
 CORDOCENTESIS/
PERCUTENEOUS UMBILICAL
CORD SAMPLING
PERCUTENEOUS UMBILICAL CORD SAMPLING:
In 1982, Bong and Association reported Umbilical blood sampling and direct transfusion of a severely
anemic D-is immunized fetus.

Techniques:
Umbilical cord sampling is generally performed with a 20-25-gauge spinal needle consideration for
anesthesia and aseptic techniques the two basic approaches to the umbilical cord are with placenta anterior,
the needle is introduced transcervical, without entering the amniotic cavity to puncture the umbilical cord at
base.

With the posterior placenta, the needle passes through the amniotic fluid to penetrate the umbilical cord at its
base with a posterior placenta the needle passes through the amniotic fluid to penetrate the umbilical cord 1
to 2 cm. from its insertion when the placenta is fundal or lateral or when fetal position precludes an approach
to the cord insertion of a posterior placenta a free loop of cord is punctured, the site depending upon the
technical case.

An initial 0.5ml sample of blood is obtained with a syringe and discarded either the umbilical vein or artery
may be used, although complications such as bleeding from the umbilical cord is generally of very short
duration and can be measured ultrasonically confirmation, that fetal blood has been obtained is made by
rapid analysis of mean corpuscular red cell volume in mother and fetus, the volume of fetal cell is much
larger.

Risk:
This invasive procedure may lead to abortion, preterm labour and IUFD. These may be due to bleeding, cord
hematoma formation, infection or preterm rupture of membrane, over all fetal loss is 1-4% Anti-D
immunoglobulin 100 microgram IM should be given to Rh – negative yet unimmunized women.

Indication:

 To obtain normal fetal blood values throughout gestation, it explains changes of blood gas and acid
base values with gestation and result of maternal sedation.
 Prenatal diagnosis of blood disorders.
1. Haemoglobinopathies
2. Hemophilia and B
 Auto immune thrombocytopenia
 Isoimmunization and platelet disorders
CDE disorder
All immune thrombocytopenia
 Metabolic disorder
 Fetal congenital infections
1. Toxoplasmosis
2. Rubella
3. Cytomegalovirus
4. Varicella
 Fetal karyotyping
1. Placenta mosaicism
2. Need for rapid karyotype
3. Fetal information by USG
  Fetal growth retardation
 Evaluation of fetal hypoxia
 Fetal therapy

Nurse’s role in cardiocentesis:

Pre- Procedure:
 Ask the women to drink 2-3 glasses of water one hour prior to appointment as a full bladder enables
a clear examination of uterine content and pelvic structures.
 Amniocentesis should always be preceded by explanation, education and counseling of the parents.
 Information on the procedure, potential adverse effects including the risk of pregnancy loss, potential
benefit and implications of test should be explained.
 The explanation will decrease anxiety and allow an informed consent to be made.
 Ensure the woman understand the procedure and has signed a consent form. A signed consent to be
made.
 Ensure the woman understand the procedure and has signed a consent form. A signed consent form
indicates the women’s agreement to undergo the procedure and acknowledges her awareness of the
risks involved.
 Check women’s allergy status.
 Check women’s blood group. Amniocentesis carries the risk of transplacental hemorrhage to prevent
Rh immunization, Rh negative women require blood sampling for Keilhauer and administration of
Rh immunoglobulin post procedure.

Procedure
 Assist women to change into a hospital gown.
 Set up sterile amniocentesis trolley as required by operator
 Assist operator with the procedure.

Post procedure
 Check the insertion site on completion of the procedure
 Label specimen and send to the lab with appropriate forms.
 Ensure correct labeling of specimen tubes
 Administer appropriate dose of anti-D immunoglobulin to unsensitized Rh negative women and
document.

Advise the women regarding:

 That menstrual cramps for 1-2 hours, lower abdominal discomfort for up to 48 hours, or tenderness
at insertion site may be experienced
 That vaginal fluid loss bleeding, uterine contractions or abdominal pain, fever or chills need to be
reported to her doctor. Post procedure instructions enable the women to recognize normal and
abnormal side effects and when to seek further advice and treatment
 To engage in light activity for 24 hours. Light activity will decrease uterine irritability and increase
placental blood flow.