Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation
CPT4 code
Name of the Procedure:
Ultrasonic Guidance for Intrauterine Fetal Transfusion or Cordocentesis, Imaging Supervision and Interpretation
Summary
This procedure uses ultrasound imaging to guide a needle into the uterus to either transfuse blood to a fetus or to take a sample from the umbilical cord. It is supervised by a radiologist or a maternal-fetal medicine specialist to ensure accuracy.
Purpose
This procedure is typically performed to manage severe fetal anemia or to diagnose and treat certain fetal conditions. The goals include improving fetal health and providing critical diagnostic information.
Indications
- Severe fetal anemia often due to Rh incompatibility or infections
- Diagnosing genetic disorders or infections through cord blood sampling
- Twin-to-twin transfusion syndrome in monochorionic twins
- Monitoring and treatment of other fetal conditions requiring direct access to fetal circulation
Preparation
- Fasting for a few hours prior to the procedure (as advised by the physician)
- Blood tests to check maternal health
- An ultrasound exam to determine the position of the fetus and placenta
Procedure Description
- The patient lies on an examination table.
- An ultrasound probe is placed on the abdomen to visualize the fetus, placenta, and umbilical cord.
- The skin is cleaned and a local anesthetic may be applied to numb the area.
- Using ultrasound for guidance, a thin needle is inserted through the abdomen and into the uterus to reach the umbilical cord.
- Depending on the purpose, blood may be transfused into the fetus or a blood sample may be taken.
- The procedure is monitored closely via ultrasound throughout.
Duration
Typically takes around 30 to 60 minutes.
Setting
Performed in a hospital's maternal-fetal medicine unit or an outpatient clinic specializing in fetal procedures.
Personnel
- Maternal-fetal medicine specialist or radiologist
- Ultrasound technician
- Nurse
- Occasionally, an anesthesiologist
Risks and Complications
- Bleeding or infection at the needle insertion site
- Preterm labor
- Rupture of membranes
- Fetal distress or complications
Benefits
- Immediate improvement in the health of a fetus with anemia
- Accurate diagnosis of fetal conditions
- Potential to address and correct issues that could lead to fetal demise
Recovery
- Observation in the hospital for several hours post-procedure
- Instructions to avoid strenuous activity for a few days
- Follow-up ultrasound to verify fetal well-being
Alternatives
- Non-invasive prenatal testing
- Serial ultrasounds for monitoring
- Early delivery if the fetus is viable and conditions are critical
Patient Experience
During the procedure, the patient might feel some pressure or discomfort, but pain management is provided as needed. Post-procedure, mild cramping or spotting may occur. Clear instructions are given for post-procedure care to ensure comfort and to monitor for any complications.