CPT® Code 59012

1. Indications

Cordocentesis is indicated in specific clinical situations where fetal blood analysis is necessary for diagnosis or management. The following conditions may warrant the performance of this procedure:

• Genetic Disorders The procedure is often indicated when there is a suspicion of chromosomal abnormalities or genetic disorders in the fetus, allowing for early diagnosis and potential intervention.
• Fetal Anemia Cordocentesis may be performed to assess fetal anemia, particularly in cases where the mother is Rh-negative and there is a risk of hemolytic disease of the newborn.
• Infections The procedure can be utilized to evaluate the presence of infections in the fetus, such as congenital infections that may affect fetal health.
• Blood Type Determination In situations where the fetal blood type is uncertain, cordocentesis can help determine the blood type to manage potential Rh incompatibility.

2. Procedure

The procedure of cordocentesis involves several critical steps to ensure the safe and effective collection of fetal blood. Each step is performed with precision and care to minimize risks to both the mother and fetus.

• Step 1: Preparation The physician begins by preparing the mother for the procedure, which includes obtaining informed consent and ensuring that the patient understands the risks and benefits. The mother is positioned comfortably, and the abdomen is cleaned and sterilized to reduce the risk of infection.
• Step 2: Ultrasonic Guidance Using ultrasound imaging, the physician locates the umbilical cord and identifies the appropriate blood vessel, either the umbilical artery or vein. This imaging is crucial for guiding the needle accurately and safely.
• Step 3: Needle Insertion A thin, sterile needle is then carefully inserted through the abdominal wall and into the identified umbilical vessel. The physician takes great care to avoid any surrounding structures and to ensure that the needle is positioned correctly within the vessel.
• Step 4: Blood Aspiration Once the needle is in place, fetal blood is aspirated into a syringe. This blood sample is essential for the subsequent analysis and diagnosis of any potential fetal conditions.
• Step 5: Needle Removal After the blood sample has been collected, the needle is gently removed from the abdomen. The physician may apply pressure to the site to minimize bleeding and ensure proper closure of the puncture site.

3. Post-Procedure

Following the cordocentesis procedure, the mother is typically monitored for any immediate complications, such as bleeding or signs of infection. It is common for the healthcare team to perform an ultrasound to confirm the well-being of the fetus after the procedure. Patients may be advised to rest and avoid strenuous activities for a short period following the procedure. Additionally, the physician may provide specific instructions regarding signs and symptoms to watch for, such as abdominal pain, fever, or decreased fetal movement, which should prompt immediate medical attention. The results of the fetal blood analysis will be communicated to the patient, and further management will be discussed based on the findings.