Balasubramanian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We discuss the current indications, technical variation and procedure-related complications of percutaneous umbilical cord blood sampling (PUBS). The term PUBS is commonly used in the United States. Cordocentesis and funipuncture are equivalent terms. A needle guided by ultrasound is introduced into a blood vessel (usually the vein) of the umbilical cord to collect fetal specimen in PUBS.We conducted a literature search in PubMed indexed journals and analyzed all related articles on PUBS and cordocentesis. We chose this subject because it is a relatively new but convenient method that has both diagnostic and therapeutic value in fetal medicine. At present the only procedure that provides direct access to fetal circulation is PUBS. The most common clinical indication for PUBS is suspected fetal anemia. Other major indications for PUBS are the diagnosis of congenital infections, cytogenetic analysis, metabolic disorders, fetal growth restriction and hematologic disorders. Therapeutic applications of cordocentesis or puncture of the umbilical cord are in utero transfusions for rhesus alloimmunization and medication administration. PUBS also provides a direct assessment of fetal thyroid function diagnosing fetal thyroid disorders and helps administer therapy in utero.
A large number of children and youth have been affected worldwide during the coronavirus disease 2019 (COVID-19) pandemic. Apart from the obvious medical and financial impacts of the COVID-19 pandemic, there has been an immense amount of psychosocial impact specifically on children and adolescents ranging from parents losing their jobs leading to financial hardships to school closure leading to not having significant interaction with their peers and having to spend more time at home which often leads to psychosocial conflicts. According to the literature review, in recent times, there has been worsening of mental health illnesses, increased suicide attempts, and severity of suicide attempts which has led to more visits to the hospitals and clinics with psychiatric concerns. There has been a pattern of increasing patient acuity in inpatient psychiatric units, more specifically in the pediatric units. The average length of stay for inpatient units has been increasing in the pediatric psychiatric units and an unfortunate downside of which has been noted to be increased lag time for placements in foster care systems or residential treatment centers in recent times. Here, we present cases of three teenagers who faced significant challenges in obtaining placement to foster care systems or residential treatment centers in the context of longer wait times experienced for intensive-out-of-home treatment services during the COVID-19 pandemic and discuss potential solutions to this issue.
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