CVS in early pregnancy
I am 42 and trying to conceive. I had an amniocentesis in a previous pregnancy but I'm considering CVS if I conceive. Does it carry an increased risk of miscarriage?
Question:Peg Plumbo CNM
Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more
Both transcervical and transabdominal CVS appear to be equally safe procedures, according to Gabbe's text, "Obstetrics: Normal and Problem Pregnancie"s (1996). In one study they quoted, the loss rate for normal fetuses through 28 weeks was 2.5 percent for transcervical approach and 2.3 percent for the transabdominal. The optimal time for CVS is 10 to 12 weeks of gestation.
A large national study also showed that pregnancy loss rates after CVS are not different from loss rates after amniocentesis. The "excess loss rate" in the CVS group over the amnio group was 0.8 percent. Variables shown to influence fetal loss rates adversely in CVS include location of the placenta in the fundus or uppermost segment of the uterus (as opposed to on the side wall of the uterus), number of catheter passages, and history of bleeding during the pregnancy.
In general, the provider should be well experienced in both procedures (cervical and abdominal) and he or she should probably decide which is suitable. For example, if the placenta is fundal, a transabdominal approach would be preferable. If the uterus is retroverted, a transcervical approach might be best.
In experienced hands, the risks for both types of procedures appear to be very similar and not much different from the risks of amnio. The main advantage to CVS is that it can be done earlier.
I hope this helps, and if you decide to have the testing, I hope all goes well for you.
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