Fetal MRI and Cordocentesis

devansic

So on Monday, I'm getting a Fetal MRI and a Cordocentesis.  We'll be 21 weeks tomorrow and I've never had these procedures before.  Anybody have experience with this?

 

cll

I had a fetal mri.  Not sure what cordocentesis is though.  I had a fetal mri b/c the peri thought they saw something on this cerebellum.  I was instructed by the center not too eat too much before the mri so the baby wouldn't move around so much.  It's can be hard to get the pics they need if the baby is moving around too much.  I was in the machine for about 45 minutes which they were surprised about because it usually takes longer if the baby is  very active. Have you ever had an MRI?  I did before this and it's not that bad unless you tend to be claustrophobic.GL.  I am sure everything will be okay.

hrhmary

Ditto pp about the fetal MRI...

Totally not a big deal.  Be sure to ask specifically when you should stop eating and/or drinking before the procedure.  I was told nothing at all to eat or drink after 8am (mri wasn't until 4).  It was pretty tough, especially when you think of how much water we're all used to drinking while pregnant!  Anyway, when I got there, it turned out I could've had all the water I wanted - they gave me the instructions for a peds patient (I had the mri at the children's hospital) who they always sedate.  Ugh. 

Also, the (all male) techs who were running the mri saw that DS's cord was around his neck (totally common and not a big deal) and they freaked out!  They called my ob and peri, wanting to know what they should do about it!  They didn't tell me why they were acting so strangely, though (I guess since the radiologist is the only one allowed to talk about the readings).  My ob and I had a good laugh about it at my appointment the next week.

Good luck - hope everything turns out well!

 Mary

devansic

Thank you!

They've got me scheduled for 6:30 in the morning for mine, so I guess I'll skip the OJ and wait until afterwards for breakfast.

I've had MRI's before, but as you've hinted, can't imagine the baby holding still for this.

Thanks again for the input, it's funny how new procedures make you so nervous! 

Kadyra

A cordocentesis is where they take a sampling of baby's blood from the umbilical cord under ultrasound guidance.  I have seen 2 or 3 of them, and they are usually done when they're concerned with anemia and exposue to infections (at least where I work).  They're looking for how anemic baby is (hemoglobin/hematocrit), antibody titer to viral or parasitic infections, all based on what diagnosis they're working with.  They can also do PUBS (peri-umbilical blood sampling and fetal blood transfusions) during a cordocentesis.  So there's a lot that can be done. 

It's fairly safe-- the needle is the same guage they use for you or me, but it's long because the cord is obviously far away, so the risk for bleeding is low.  There's a risk for touching the baby in other areas with the needle, but this risk is minimal because of the ultrasound guidance-- that being said, they can't control the baby's movements.  I have had baby's grab the needle and not let go, so anything is possible.  You just wait and continue when baby is done playing.  There's a risk of bleeding from the placenta if its touched by the needle, but because the needle is small, this is usually insignificant and short-lived.  It very rarely cases a large abruption unless you are already at risk for one.  You can get cramping and some contractions from this, but they will likely prescribe some medicine that is safe for baby to prevent that.  The scariest thing for you will likely be the risk of breaking your water from this.  It's about a 1-2% risk.  However, if this happens, it's usually a small leak that reseals, not a big gush where you'll go into labor and have your baby.  So that's more reassuring.  In my career, I've only had one patient have their water break and they already had an abruption and her water broke more than the little leak and reseal.  She stayed pregnant from 19 weeks to almost 27 weeks and her baby did great.  She delivered the last night I worked, actually.

So those are some things about it.  They're the same risks of an amnio.  But it sounds like your benefits of having this procedure outweigh your risks, since you have enough complications to necessitate it as well as the fetal MRI.  I've never had a patient have a fetal MRI, but I can see why it'd be necessary under certain circumstances.  Getting an MRI of your belly is a lot less clausterphobic than getting one of your head!  It's loud, but nice and safe for baby.

HTH.

devansic

Hi Andrea,

Thank you for the input!  We are having the MRI and Cordo because we are concerned about the baby's platelet count.  I've been on IVIG for 8 weeks and we're basically checking to see if the treatment is working?  If the platelet count is good, we keep going with the treatment, if not, they start me on steroids and will do a platelet transfusion.

My understanding is that the risks are low, but I've never had this done before, and I'm paranoid.  Thank you so much for the input, every little bit helps me calm down.

Danielle 

Kadyra

No problem.  Good luck with your procedures!!!