CVS

Chorionic villus sampling (CVS)

Chorionic villus sampling (CVS) is a prenatal test in which a sample of chorionic villi is removed from the placenta for testing.

During pregnancy, the placenta provides oxygen and nutrients to the growing baby and removes waste products from the baby's blood. The chorionic villi are wispy projections that make up most of the placenta and share the baby's genetic makeup.

Chorionic villus sampling can reveal whether a baby has a chromosomal condition, such as Down syndrome. Chorionic villus sampling can also be used to test for other genetic conditions, such as cystic fibrosis.

Although chorionic villus sampling can provide valuable information about your baby's health, the decision to pursue invasive diagnostic testing is serious. It's important to understand the risks of chorionic villus sampling — and be prepared for the results.

 

Risks

·         Miscarriage. Overall, chorionic villus sampling carries a 1 in 100 risk of miscarriage. The risk of miscarriage appears to be slightly higher when the tissue sample is taken through the cervix (trans cervical) rather than the abdominal wall (trans abdominal). The risk of miscarriage also increases if the baby is smaller than normal for his or her gestational age.

·         Rh sensitization. Chorionic villus sampling might cause some of the baby's blood cells to enter your bloodstream. If you have Rh negative blood and you haven't developed antibodies to Rh positive blood, you'll be given a drug called Rh immunoglobulin after the test to prevent you from producing antibodies against your baby's blood cells. A blood test can detect if you've begun to produce antibodies.

·         Infection. Rarely, chorionic villus sampling might trigger a uterine infection.

Some older studies suggested that chorionic villus sampling might cause defects in a baby's fingers or toes. However, the risk appears to be a concern only if the procedure is done before week nine of pregnancy.

Remember, chorionic villus sampling is typically offered when the test results might have a significant impact on the management of the pregnancy. Ultimately, the decision to have chorionic villus sampling is up to you. Your health care provider or genetic counselor can help you weigh all the factors in the decision.

 

How you prepare

You might need to have a full bladder for chorionic villus sampling, so drink plenty of fluids before your appointment. Depending on the position of the placenta, however, you might be asked to empty your bladder just before the procedure.

Your health care provider might ask you to sign a consent form before the procedure begins. Consider asking someone to accompany you to the appointment for emotional support or to drive you home afterward.

Trans cervical chorionic villus sampling

If the placenta is in a favorable position, your health care provider might take the sample through your cervix. After cleansing your vagina and cervix with an antiseptic, he or she will open your vagina with a speculum and insert a thin, hollow tube through your cervix. When the catheter reaches the placenta, gentle suction will be used to remove a small tissue sample. You might feel cramping while the tissue sample is removed.

Trans abdominal chorionic villus sampling

 If the placenta isn't clearly accessible through the cervix or you have a cervical infection, such as herpes, your health care provider might take the sample through a needle inserted into your uterus. After cleansing your abdomen with an antiseptic, he or she will insert a long, thin needle through your abdominal wall and into your uterus. You might notice a stinging sensation when the needle enters your skin, and you might feel cramping when the needle enters your uterus. The tissue sample from the placenta will be withdrawn into a syringe, and the needle will be removed.

You'll need to lie still while the tissue sample is removed. The entire procedure usually takes about 30 minutes.

If your health care provider isn't able to remove an adequate amount of tissue on the first try, the procedure might need to be repeated.

After the procedure

After the tissue sample is removed, your health care provider might use ultrasound to monitor your baby's heart rate. You might experience a small amount of vaginal bleeding immediately after the procedure.


The tissue sample will be analyzed in a lab. Results might take a few days or a couple of weeks, depending on the complexity of the lab analysis.

Contact your health care provider if you have:
 
·         Fluid leaking from your vagina

·         Heavy bleeding

·         A fever

·         Uterine contractions