The placenta is the link between mother and baby during pregnancy. Two arteries and one vein in the umbilical cord carry blood back and forth. If the newborn baby is ill right after birth, a catheter may be placed. An umbilical artery catheter (UAC) allows blood to be taken from an infant at different times, without repeated needle sticks. It can also be used to continuously monitor a baby's blood pressure.
An umbilical artery catheter is most often used if:
The baby needs breathing help.
The baby needs blood gases and blood pressure monitored.
The baby needs strong medicines for blood pressure.
An umbilical venous catheter (UVC) allows fluids and medicines to be given without frequently replacing an intravenous (IV) line.
An umbilical venous catheter may be used if:
The baby is very premature.
The baby has bowel problems that prevent feeding.
The baby needs very strong medicines.
The baby needs exchange transfusion.
- To draw blood frequently to be tested without causing additional pain to the baby
- To administer intravenous fluids, nutrition, and high-concentration medication
- To carry out a blood transfusion
- To monitor a baby’s blood pressure
-Risks associated with the procedure such as blood clots and infections
The procedure is performed in the Neonatal Intensive Care Unit (NICU) by a neonatologist in a sterile environment and using sterile equipment. An x-ray will be done to ensure the catheter is in the correct location. The catheter will be removed when it is no longer needed, usually within two weeks of it being put in place.
No special preparation is necessary. The procedure will be carried out while the child is positioned on a warming bed. Their vital signs will be monitored throughout the procedure. There is no need to avoid milk or water before the procedure.
The nurse will clean around the area twice a day with Betadine and observe it for any problems.
Central venous catheterization is an invasive form of vascular access, and many potential
complications are associated with this technique :
-Arterial injury: The most common complication of this technique is accidental puncture and/or cannulation of the adjacent artery. In most cases, this results in a minor injury to the artery that can be easily managed with direct
pressure at the insertion site or by application of a pressure dressing
-Infection: Central venous catheters are foreign bodies and can, like any such object, become colonized by bacteria.
Thrombosis: Just as any foreign object can become infected, almost any foreign object can become a nidus for thrombus formation
-Guidewire misplacement: In rare instances, the guidewire enters the central venous circulation and must be retrieved by an angiographer or a surgeon.
-Air embolus: This complication is most likely to occur when the catheter is placed into the internal jugular vein or the subclavian vein
How are umbilical catheters placed?
There are normally two umbilical arteries and one umbilical vein in the umbilical cord. After the umbilical cord is cut off, the health care provider can find these blood vessels. The catheters are placed into the blood vessel, and an x-ray is taken to determine the final position. Once the catheters are in the right position, they are held in place with silk thread. Sometimes, the catheters are taped to the baby's belly area.