Invasive Procedures
CVS is a test accomplished to test for all types of chromosomal abnormalities and prenatal prognosis of certain genetic disorders and problems like thalassemia in the baby.
Why is it done?
Frequently it’s practised to rule out chromosomal and genetic disorders within the infant and is advisable in the following conditions:
- When there is a ‘high risk’ for chromosomal problems on first trimester screening)
- When there’s an abnormality in the toddler on the primary trimester test
- To rule out genetic problems like thalassemia, sickle cell anemia, muscular dystrophy etc.
- If you have a historical family hereditary record of a genetic sickness for which the genetic mutation is known.
How is it done?
CVS is carried out with the aid of passing a needle through the mom’s tummy, under doze of local anaesthesia to achieve a small quantity of tissue from the placenta It is carried out under continuous ultrasound guidance as a way to avoid harm to the baby. In a few instances, the needle may be needed to put second time if sufficient tissue isn’t obtained in the first attempt.
It is done at 11 to 13 weeks of pregnancy. We opt to do it at around 12 weeks whilst we can do the primary trimester screening properly and rule out any structural abnormality in the child. The placental tissue is dispatched to the laboratory for testing. For some tests, dad and mom blood samples are also asked.
How painful is it? Will I be given anaesthesia?
Anaesthesia is given prior to the process. Majority of women undergoing the practice, mention it as uncomfortable or as painful as process of blood sampling.
What are the risks associated with it?
There may be small increased risk of miscarriage of around 1 in 100 for chorionic villus sampling. Although all precautions are taken at each stage in the practice to reduce contamination and infection, there remains a small danger of infection (1 in 1000). In about 1 in a hundred sufferers, the subculture may additionally fail and the full karyotype may be unavailable. In some cases, the results may also take longer or might not be available because of mosaicism. If a complete karyotype remains wanted, the medical doctor will offer you amniocentesis after 15 weeks.
What should I expect before the procedure?
The practice, its indication and the related dangers may be mentioned with you and you may be requested to sign a knowledgeable consent. Your blood group and other blood tests (HIV, Hepatitis B) will be checked.
What should I expect before the procedure?
You may be requested to rest and the baby’s heart beat might be checked after 1/2 an hour. You could have moderate bruising on the site of needle puncture. You can additionally have some spotting or slight cramping for a couple of hours.You may take oral paracetamol that is absolutely safe in pregnancy.
There is no restriction in your daily activities though the medical doctor can also advice you to stay at rest for three days to limit and lower the chances of infection. If you have fever, vaginal bleeding or leaking or contractions, you ought to reach and inform to the health facility centre.
How long do the results take to come?
The FISH report comes inside 3 full running days; the karyotype report takes two to three weeks. The timing of different results will depend on the test done and commonly varies between seven to ten running days. You’ll be approached as quickly as the reports are available and a soft copy can be mailed to you on the very same day.
Fetal Blood Sampling
Amniocentesis is a test performed at some point of pregnancy to check for chromosomal problems, genetic disorders and infections in the fetus.
Why is it done?
- When there’s a ‘high risk’ for chromosomal problems on first trimester or at 2nd trimester screening (triple or quadruple marker)
- When there may be a excessive suspicion for Down syndrome on ultrasound in the second trimester
- When there is an abnormality inside the baby at the scan
- To rule out certain genetic disorders like SLO syndrome, icthyosis and so on.
- Amniocentesis can be performed to affirm fetal infection whilst the mother is suspected to have infections, like rubella, CMV, toxoplasma, and so on.
How is it done?
In Amniocentesis, a thin needle via the mom’s tummy to reap a small quantity of amniotic fluid from around the fetus. It is practiced under continuous ultrasound guidance in order that the needle avoids both the baby in addition to the placenta. Every so often, the needle can also require to be inserted two times to reap an adequate fluid.
This process is commonly completed between 15 to 18 weeks of pregnancy; however it is able to be performed every time afterwards while indicated. Amniotic fluid carries the infant’s cells which can be analysed in the lab. Fluorescent In Situ Hybridization (FISH) technique assessments for the maximum common chromosomal abnormalities, specifically trisomy 21 (Down syndrome), trisomy 18 (Edward’s syndrome), trisomy thirteen (Patau’s syndrome) and the sex chromosomes. A complete karyotype which indicates all of the 46 chromosomes of the fetus is carried out by culturing the fetal cells.
How painful is it? Will I be given anaesthesia?
Majority of women undergoing the process claims it as unpleasant or painful likely as of blood sampling. Nominal local anaesthesia is given for amniocentesis.
What are the risks associated with it?
There may be small hazard of miscarriage of round 1 in 200 with amniocentesis and 1 in 100 for chronic villus sampling. Even though all precautions are taken at some stage in the process to decrease contamination, there stays a small threat of infection (1 in one thousand). In about 1 in one hundred patients, the subculture might also fail and the full karyotype may be unavailable.
What should I expect before the procedure?
The health practitioner will provide an explanation for the process, why it need to be done and the associated risk hazards as mentioned above. You will be asked to sign an informed consent. Your blood group and few other blood assessments (HIV, Hepatitis B) might be asked to be checked.
What should I expect before the procedure?
You’ll be requested to relax within the department and the fetus heart beat may be checked after half of an hour. There may be no restrict in your daily activity and work even though the physician may additionally advice you to rest at home for three days to decrease probabilities of contamination and infection.
You can have moderate bruising at the site of needle access. You can additionally have slight cramping for more than one hour. If you have fever, vaginal bleeding or leaking or contractions, you must approach to the medical institution or doctor.
How long do the results take to come?
The FISH record comes inside three full working days; the karyotype report takes 2 to three weeks. The timing of different results will rely upon the test carried out and normally varies among 7 to 10 working days. You may obtain a call from us as quickly because the reviews are meant to be had tendered soft copy may be mailed to you at the very same day.
Embryo Reduction
In case of multiple pregnancy , it’s far really helpful to lessen the number of fetuses to two, in order to decrease risks of more than one pregnancy to the mother as well as to the fetuses.
Why is it advised?
As the number of fetuses increase, the dangers of preterm (early) baby delivery also grows with the same ratio. The average duration of pregnancy for a singleton is 40 weeks while for twins it’s 36 weeks. This reduces dramatically to 32 to 33 weeks for triplets and 28 to 29 weeks for quadruplets.
The prevalence of multiple pregnancy is increasing worldwide mainly because of increase in the availability and uptake of synthetic reproductive techniques.
When is embryo reduction done?
It can be done from eleven to thirteen weeks of being pregnant; at our centres, we favour to do it at around 12 weeks when we are able to do the first trimester screening and also rule out any structural abnormality in the fetus. In addition, approximately 8 to 20% of pregnancies may additionally reduce by way of themselves at the end of first trimester. The ‘vanishing’ twin does not have any destructive impact on the surviving fetus.
How is it done?
Embryo reduction is done by passing a needle via the mom’s tummy under nominal local anaesthesia and injecting a medicine into the fetus. It’s executed under continuous ultrasound guidance.
What are the risk associates to the procedure?
After fetal reduction, there is a 7 % threat that the woman will lose the entire pregnancy earlier to 20 weeks’ gestation. The original number of fetuses, the direction of the needle in addition to the number terminated may also affect the probability and the chances of pregnancy loss.
What should I expect after the procedure?
You’ll be requested to rest and the fetus heart beat can be checked after half of an hour of the process. You could have moderate bruising on the site of needle entry. You could additionally have some spotting or mild cramping for multiple hours for which you can take oral paracetamol. There may be no restriction for your day to day activities though the physician might also advice you to stay home for 3 days to decrease possibilities of contamination.
When you have fever, vaginal bleeding or leaking or contractions, you must come to the health practitioner or hospital.
