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Your Pregnancy After 35 : Tests for You and Your Baby (part 6) - Chorionic Villus Sampling,Fetoscopy, Fetal Fibronectin , Percutaneous Umbilical Blood Sampling

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Chorionic Villus Sampling (CVS)

Chorionic villus sampling (CVS) analyzes chorionic villus cells, which eventually become the placenta. The test detects genetic abnormalities; sampling is done early in pregnancy. The advantage of CVS is that a healthcare provider can diagnose a problem earlier in pregnancy.

The test can be done at 9 to 11 weeks instead of 16 to 18 weeks, as with amniocentesis. Some women choose CVS so they can make a decision about their pregnancy earlier. If a woman decides to terminate a pregnancy, the procedure may carry fewer risks when performed earlier in pregnancy.

To perform the test, an instrument is placed through the cervix or through the abdomen to remove a small piece of tissue from the placenta. If your doctor recommends CVS, ask about its risks. The test should be performed only by someone experienced with the technique. The risk of miscarriage is small—between 1 and 2%—and the test is considered as safe as amniocentesis. If you have CVS and are Rh-negative, you should receive RhoGAM after the procedure.

A special listening machine, called a doppler, magnifies the sound of the baby’s heartbeat so it can be heard. It’s usually possible to hear the baby’s heartbeat around your 12-week visit.

Fetoscopy

Because of advances in fiber optics, we are able to look at a fetus or placenta as early as 10 weeks into its development. Ultrasound cannot provide the same degree of detail. Fetoscopy enables the healthcare provider to look through a fetoscope to detect even subtle abnormalities and problems.

The healthcare provider makes a small incision in the mother’s abdomen and places a small scope through the abdomen and uterus. The healthcare provider uses the fetoscope to examine the fetus and placenta.

The test is specialized and is not done very often. It is usually recommended if you have given birth to a child with a birth defect that cannot be detected by any other test. If your healthcare provider suggests fetoscopy to you, discuss it with him or her. The risk of miscarriage is 3 to 4%. Only someone experienced at it should do the procedure.

Fetal Fibronectin (fFN)

It can be difficult to determine if a woman is at risk of delivering a preterm baby. Many symptoms of preterm labor mimic various discomforts of pregnancy. However, a test is available that can help doctors make this determination.

Fetal fibronectin (fFN) is a protein found in the amniotic sac and fetal membranes. After 22 weeks of pregnancy, fFN is not normally present until around week 38.

When present in cervical-vaginal secretions of a pregnant woman after 22 weeks (before week 38), it indicates increased risk for preterm delivery. If absent, risk of premature labor is low, and the woman probably won’t deliver within the next 2 weeks. fFN can rule out early delivery with 99% accuracy.

The test is performed like a Pap smear. A swab of vaginal secretions is taken from the top of the vagina, behind the cervix. It is sent to the lab, and results are available within 24 hours.

Percutaneous Umbilical Blood Sampling (PUBS)

Percutaneous umbilical blood sampling (PUBS), also called cordocentesis, is a test done on the fetus while it is still inside the uterus. The test has improved the diagnosis and treatment of Rh-incompatibility and other blood disorders. Results can be available within a few days, but it carries a slightly higher risk of miscarriage than amniocentesis does.

Guided by ultrasound, a fine needle is inserted through the mother’s abdomen into a tiny vein in the umbilical cord of the fetus. A small sample of the baby’s blood is removed for analysis. Blood disorders, infections and Rh-incompatibility are detectable with PUBS.

If the fetus is found to be Rh-positive and its mother is Rh-negative, healthcare providers have time to give it a blood transfusion, if necessary. This procedure can help prevent life-threatening anemia that can develop if the mother is isoimmunized (she has antibodies that attack her baby’s blood).If you are Rh-negative, you should receive RhoGAM after this procedure.

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