Umbilical Cord Puncture

Umbilical cord puncture, also called “choracentesis”, is a voluntary, painless but invasive method of prenatal diagnostics, i.e. special prenatal care. The umbilical vein of the baby is punctured with a long and thin needle through the mother’s abdominal wall. The position of the puncture needle is constantly monitored by a parallel ultrasound.

The collected blood (approximately one to two milliliters) is then examined in the laboratory. The diagnostic spectrum ranges from the determination of the blood count, i.e. the number and form of the individual blood cells, as well as various antibodies that may indicate various diseases, the detection of infections and metabolic disorders, to chromosome determination. An umbilical cord puncture is not a routine examination and must therefore be requested by the parents.

In most cases, only the blood values are determined. This means for example the blood group with the rhesus factor, the hematocrit and the blood cells, the hemoglobin content, as well as antibodies to certain infections (rubella, herpes, toxoplasmosis). Chromosomal examination, which can detect a wide range of hereditary diseases, is rather rare.

With invasive examination methods there are always risks. In rare and exceptional cases, umbilical cord puncture can lead to loss of amniotic fluid, infections, injuries to the mother and fetus caused by the needle, bleeding, and miscarriage. The necessity of such an examination should therefore be well discussed and weighed up in advance in a consultation between the doctor and the pregnant woman/parents.

The umbilical cord prolapse

A distinction is made between a “presence of the umbilical cord” and a “prolapse of the umbilical cord”. A prolapse of the umbilical cord refers to a situation in which the umbilical cord is placed in front of the preceding part of the baby’s body, while the amniotic sac is still intact. The umbilical cord can be reduced prenatally by positioning the pregnant woman and is therefore not an exclusion of a vaginal birth, but should be constantly monitored.

An umbilical cord prolapse, on the other hand, is a medical emergency in which the umbilical cord is placed in front of the preceding part of the baby’s body due to a premature rupture of the bladder or during birth. Thereby it can come to a jamming of the umbilical cord. However, since the umbilical cord is responsible for supplying the baby with oxygen, immediate intervention is necessary to prevent permanent damage to the child.The pelvis of the pregnant woman is raised to reduce the pressure on the umbilical cord. A vaginal birth is then usually ruled out and the child is born by caesarean section.